Provider Demographics
NPI:1174810741
Name:HUSSAIN, SAJJAD (MD)
Entity type:Individual
Prefix:
First Name:SAJJAD
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 ROLLING MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6189
Mailing Address - Country:US
Mailing Address - Phone:734-369-8913
Mailing Address - Fax:
Practice Address - Street 1:1780 E PARNALL RD
Practice Address - Street 2:PARNALL CORRECTION FACILITY - HEALTH CARE CENTER
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-7136
Practice Address - Country:US
Practice Address - Phone:517-780-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094288207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine