Healthcare Provider Details

I. General information

NPI: 1477049559
Provider Name (Legal Business Name): AYMAN ALI USMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HIGHLAND AVE STE 101
SALEM MA
01970-2100
US

IV. Provider business mailing address

55 HIGHLAND AVE
SALEM MA
01970-2185
US

V. Phone/Fax

Practice location:
  • Phone: 978-741-4171
  • Fax:
Mailing address:
  • Phone: 978-741-4171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number1019131
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: