Provider Demographics
NPI:1043316946
Name:GEORGE, USHA (MD)
Entity type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 N HIGHWAY A1A STE D101
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-9513
Mailing Address - Country:US
Mailing Address - Phone:561-327-9222
Mailing Address - Fax:561-879-4448
Practice Address - Street 1:725 N HIGHWAY A1A STE D101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-9513
Practice Address - Country:US
Practice Address - Phone:561-327-9222
Practice Address - Fax:561-879-4448
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME153343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00718878Medicaid
NY00718878Medicaid
NYUG054A4110Medicare ID - Type Unspecified