Healthcare Provider Details

I. General information

NPI: 1013968817
Provider Name (Legal Business Name): ALI USMANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MCKNIGHT DR SUITE A
MIDDLETOWN OH
45044-4890
US

IV. Provider business mailing address

103 MCKNIGHT DR SUITE A
MIDDLETOWN OH
45044-4890
US

V. Phone/Fax

Practice location:
  • Phone: 513-217-6400
  • Fax: 513-217-6037
Mailing address:
  • Phone: 513-217-6400
  • Fax: 513-217-6037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35086083
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35086083
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35086083
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: