Provider Demographics
NPI:1841308442
Name:QURESHI, NAUMAN (MD)
Entity type:Individual
Prefix:
First Name:NAUMAN
Middle Name:
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W MARKET ST STE 16
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2454
Mailing Address - Country:US
Mailing Address - Phone:256-232-0801
Mailing Address - Fax:256-232-5918
Practice Address - Street 1:1005 W MARKET ST STE 16
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2454
Practice Address - Country:US
Practice Address - Phone:256-232-0801
Practice Address - Fax:256-232-5918
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10609174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11017Medicaid
AL000011017Medicare UPIN
AL11017Medicaid
ALC76962Medicare UPIN