MEDICARE: AHSAN IMRAN USMANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	35.087875	OH
2	208VP0014X	Interventional Pain Medicine Physician	35.087875	OH
3	208VP0014X	Interventional Pain Medicine Physician	01068862A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7907789	OTHER		AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	503223	OTHER	OH	ANTHEM BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336133289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHSAN IMRAN USMANI MD

Provider Business Mailing Address
First Line	:	1100 REID PARKWAY
Second Line	:	MEDICAL STAFF SERVICES
City	:	RICHMOND
State	:	IN
Zip	:	47374
Country	:	US
Telephone Number	:	765-935-8802
Fax Number	:	765-983-3219

Provider Business Practice Location Address
First Line	:	1400 HIGHLAND RD STE 1
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-8810
Country	:	US
Telephone Number	:	765-935-8866
Fax Number	:	765-935-8865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	01/20/2022

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Directions to “ AHSAN IMRAN USMANI MD” Practice Location

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