Healthcare Provider Details

I. General information

NPI: 1396965513
Provider Name (Legal Business Name): MUHAMMAD USMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 SAINT ANDREWS WAY
PHENIX CITY AL
36867-7453
US

IV. Provider business mailing address

1806 SAINT ANDREWS WAY
PHENIX CITY AL
36867-7453
US

V. Phone/Fax

Practice location:
  • Phone: 706-566-7035
  • Fax:
Mailing address:
  • Phone: 706-566-7035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number020006
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: