Healthcare Provider Details

I. General information

NPI: 1881960367
Provider Name (Legal Business Name): ASAD ALI USMAN MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE STREET
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

3400 SPRUCE STREET
PHILADELPHIA PA
19104-4206
US

V. Phone/Fax

Practice location:
  • Phone: 215-349-8310
  • Fax: 215-893-7270
Mailing address:
  • Phone: 215-349-8310
  • Fax: 215-893-7270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD463459
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: