Provider Demographics
NPI:1871545269
Name:QURAISHI, MOHAMMED FAREED (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:FAREED
Last Name:QURAISHI
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 1:17310 WRIGHT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2405
Mailing Address - Country:US
Mailing Address - Phone:833-228-6889
Mailing Address - Fax:877-853-0376
Practice Address - Street 1:17310 WRIGHT ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2405
Practice Address - Country:US
Practice Address - Phone:833-228-6889
Practice Address - Fax:877-853-0376
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUMC-1642085R0202X
WY10414A2085R0202X
MO20150442332085R0202X
ND151392085R0202X
WAMD000461232085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA207551OtherL & I
WAP00320105OtherRAILROAD MEDICARE
WA8449225Medicaid
WA8449225Medicaid
WA207551OtherL & I
I53123Medicare UPIN