Healthcare Provider Details

I. General information

NPI: 1659782944
Provider Name (Legal Business Name): HASSAN USMANI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 GATEWAY BLVD N
CHESTERTON IN
46304-9658
US

IV. Provider business mailing address

601 GATEWAY BLVD N
CHESTERTON IN
46304-9658
US

V. Phone/Fax

Practice location:
  • Phone: 219-921-1444
  • Fax: 219-921-5303
Mailing address:
  • Phone: 219-921-1444
  • Fax: 219-921-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001290A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2321
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: