Provider Demographics
NPI:1932540960
Name:SALAHUDDIN, USMAN I (MBBS)
Entity Type:Individual
Prefix:
First Name:USMAN
Middle Name:I
Last Name:SALAHUDDIN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4190
Mailing Address - Country:US
Mailing Address - Phone:601-703-4531
Mailing Address - Fax:601-703-3047
Practice Address - Street 1:1800 12TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4190
Practice Address - Country:US
Practice Address - Phone:601-703-4531
Practice Address - Fax:601-703-3047
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10047498390200000X
MS27555207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program