Healthcare Provider Details

I. General information

NPI: 1932779022
Provider Name (Legal Business Name): AREEB USMANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 E 34TH ST
JOPLIN MO
64804-3932
US

IV. Provider business mailing address

1105 E 32ND ST STE 1
JOPLIN MO
64804-2876
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-7603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2021025240
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: