Basic Information
Provider Information
NPI: 1881960367
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: USMAN
FirstName: ASAD
MiddleName: ALI
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 SPRUCE STREET
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191044206
CountryCode: US
TelephoneNumber: 2153498310
FaxNumber: 2158937270
Practice Location
Address1: 3400 SPRUCE STREET
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191044206
CountryCode: US
TelephoneNumber: 2153498310
FaxNumber: 2158937270
Other Information
ProviderEnumerationDate: 03/28/2012
LastUpdateDate: 11/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD463459PAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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