Individual
DR. MOHAMMAD TAHIR HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58778
MN
208M00000X
Hospitalist Physician
58778
MN
208M00000X
Hospitalist Physician
Primary
ME137887
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58778
MN LICENSE
MN
01
—
ME137887
FL LICENSE
FL
Enumeration date
08/22/2011
Last updated
10/07/2020
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