Provider Demographics
NPI:1154532679
Name:USMANI, MUHAMMAD IKRAMULLAH (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:IKRAMULLAH
Last Name:USMANI
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 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-326-7342
Mailing Address - Fax:
Practice Address - Street 1:460 PALM COAST PKWY SW
Practice Address - Street 2:SUITE 5
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4785
Practice Address - Country:US
Practice Address - Phone:386-246-3954
Practice Address - Fax:386-246-3960
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001335300Medicaid