Provider Demographics
NPI:1487730784
Name:HUSSEIN, BASEM MOUSTAFA (MD)
Entity type:Individual
Prefix:DR
First Name:BASEM
Middle Name:MOUSTAFA
Last Name:HUSSEIN
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 1:3945 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3507
Mailing Address - Country:US
Mailing Address - Phone:215-858-1957
Mailing Address - Fax:
Practice Address - Street 1:3945 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3507
Practice Address - Country:US
Practice Address - Phone:215-858-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-068328-L2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH59932Medicare UPIN