Healthcare Provider Details

I. General information

NPI: 1215721600
Provider Name (Legal Business Name): MUHAMMAD USMAN AWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 N 11TH ST
RICHMOND VA
23298-5024
US

IV. Provider business mailing address

VCUHS GME ADMINISTRATION PO BOX 980257
RICHMOND VA
23298-0257
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9849
  • Fax: 804-828-2744
Mailing address:
  • Phone: 804-828-9783
  • Fax: 804-828-2744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0116040519
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: