Individual
MARIYAM A HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2136 N MAIN ST, FUQUAY VARINA, NC 27526-9231
(919) 567-1607
(919) 567-1622
Mailing address
2136 N MAIN ST, FUQUAY VARINA, NC 27526-9231
(919) 567-1607
(919) 567-1622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200101219
NC
207QA0000X
Adolescent Medicine (Family Medicine) Physician
200101219
NC
207QA0505X
Adult Medicine Physician
200101219
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
200101219
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
200101219
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200101219
NC LICENSE
NC
05
—
891291W
—
NC
Enumeration date
04/21/2006
Last updated
07/02/2010
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