Healthcare Provider Details

I. General information

NPI: 1013140227
Provider Name (Legal Business Name): ASHAR UL ISLAM USMANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ASHARUL ISLAM USMANI M.D.

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N PARK PL
STOCKBRIDGE GA
30281
US

IV. Provider business mailing address

2727 PACES FERRY RD SE STE 1-1100
ATLANTA GA
30339-6151
US

V. Phone/Fax

Practice location:
  • Phone: 770-505-1500
  • Fax:
Mailing address:
  • Phone: 470-271-3418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number080998
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number080998
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: