Provider Demographics
NPI:1023073467
Name:GHAZI, USAMA (DO)
Entity type:Individual
Prefix:
First Name:USAMA
Middle Name:
Last Name:GHAZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:STE 128
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-341-0722
Mailing Address - Fax:303-341-0832
Practice Address - Street 1:2480 W 26TH AVE
Practice Address - Street 2:BLDG B STE 90
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5309
Practice Address - Country:US
Practice Address - Phone:303-572-8780
Practice Address - Fax:303-572-8783
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR44429208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805372Medicare PIN
CAI13176Medicare UPIN