Healthcare Provider Details

I. General information

NPI: 1245548841
Provider Name (Legal Business Name): USMAN GHANI PIRACHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 09/21/2023
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 KINGSBOROUGH SQ STE 100
CHESAPEAKE VA
23320
US

IV. Provider business mailing address

3241 WESTERN BRANCH BLVD STE A
CHESAPEAKE VA
23321
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-9291
  • Fax: 757-213-9342
Mailing address:
  • Phone: 767-686-3508
  • Fax: 757-686-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101261394
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101261394
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: