Individual
USMAN MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
306576
LA
207RC0000X
Cardiovascular Disease Physician
306576
LA
207RI0011X
Interventional Cardiology Physician
Primary
306576
LA
Other
Enumeration date
09/25/2012
Last updated
08/11/2023
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