Healthcare Provider Details

I. General information

NPI: 1194882761
Provider Name (Legal Business Name): SOHAIB USMANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 FOULK RD SUITE 203
WILMINGTON DE
19803-3155
US

IV. Provider business mailing address

900 FOULK RD SUITE 203
WILMINGTON DE
19803-3155
US

V. Phone/Fax

Practice location:
  • Phone: 302-778-3822
  • Fax: 302-778-3826
Mailing address:
  • Phone: 302-778-3822
  • Fax: 302-778-3826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberG1-0001218
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: