Organization
ADVANCED SPORTS & SPINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. USMAN FAYYAZ AHMAD D.O. (SOLE MEMBER)
(704) 542-3988
Entity
Organization
Contact information
Practice address
8035 PROVIDENCE RD, #340, CHARLOTTE, NC 28277-9716
(704) 542-3988
Mailing address
8035 PROVIDENCE RD STE 340, CHARLOTTE, NC 28277-9717
(704) 542-3988
(704) 542-3912
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2015-01401
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629422738
—
NC
Enumeration date
04/15/2016
Last updated
04/12/2018
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