Healthcare Provider Details

I. General information

NPI: 1831262112
Provider Name (Legal Business Name): MAHMOOD AHMED USMAN M.D., M.M.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 RODI RD
PITTSBURGH PA
15235-4566
US

IV. Provider business mailing address

PO BOX 451
GLENSHAW PA
15116-0451
US

V. Phone/Fax

Practice location:
  • Phone: 412-241-9013
  • Fax: 412-244-9252
Mailing address:
  • Phone: 412-487-2844
  • Fax: 412-487-4058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD042679L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: