Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | DR44429 | CO |
NPI | 1023073467 |
---|---|
Provider Name | Usama Ghazi |
First Address | Aurora, CO 80012-6165 |
Second Address | Denver, CO 80211-5309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 09/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I13176 | (02) | CA |