Provider Demographics
NPI:1801845284
Name:OUSMAN, YASSER HADJ (MD)
Entity Type:Individual
Prefix:
First Name:YASSER
Middle Name:HADJ
Last Name:OUSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 PROSPERITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4354
Mailing Address - Country:US
Mailing Address - Phone:877-511-4625
Mailing Address - Fax:703-698-2506
Practice Address - Street 1:2740 PROSPERITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4354
Practice Address - Country:US
Practice Address - Phone:571-623-3480
Practice Address - Fax:703-204-9006
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31598207RE0101X
PAMD478729207RE0101X
VA0101058348207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD697102400Medicaid
VA5863368Medicaid
DC025800300Medicaid
DCH55382Medicare UPIN
DC025800300Medicaid