Healthcare Provider Details

I. General information

NPI: 1568420602
Provider Name (Legal Business Name): ARIF S USMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6930 TREELINE DR STE G
BRECKSVILLE OH
44141
US

IV. Provider business mailing address

6930 TREELINE DR STE G
BRECKSVILLE OH
44141
US

V. Phone/Fax

Practice location:
  • Phone: 440-627-2040
  • Fax: 440-627-2070
Mailing address:
  • Phone: 440-627-2040
  • Fax: 440-627-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number27771
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35078311
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: