Healthcare Provider Details

I. General information

NPI: 1699695429
Provider Name (Legal Business Name): USAMA TANVEER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BATH RD
BRISTOL PA
19007-3190
US

IV. Provider business mailing address

2909 DIXON AVE
BRISTOL PA
19007-3002
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-9977
  • Fax: 215-785-9812
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT237530
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: