Provider Demographics
NPI:1144296153
Name:USEN, NSIMA (DPM, MPH, FACFAS)
Entity type:Individual
Prefix:DR
First Name:NSIMA
Middle Name:
Last Name:USEN
Suffix:
Gender:M
Credentials:DPM, MPH, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 FORD AVE
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-2304
Mailing Address - Country:US
Mailing Address - Phone:734-284-1333
Mailing Address - Fax:734-284-1311
Practice Address - Street 1:1628 FORD AVE
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-2304
Practice Address - Country:US
Practice Address - Phone:734-284-1333
Practice Address - Fax:734-284-1311
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002130213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4820453-13Medicaid
MIV06080Medicare UPIN
MI4820453-13Medicaid
MI0P21200Medicare ID - Type Unspecified