Provider Demographics
NPI:1649403882
Name:USMANI, NIDA (MD)
Entity Type:Individual
Prefix:
First Name:NIDA
Middle Name:
Last Name:USMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:
Practice Address - Street 1:200 CRESCENT CENTER PKWY
Practice Address - Street 2:KAISER PERMANENTE CRESCENT CENTRE MEDICAL CENTER
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-7047
Practice Address - Country:US
Practice Address - Phone:305-585-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 14127390200000X
GA0772182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program