Provider Demographics
NPI:1871934547
Name:QURESHI, IAN ZAFAR (DO, PHD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:ZAFAR
Last Name:QURESHI
Suffix:
Gender:M
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 E GOLDSTONE DR.
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-205-0350
Mailing Address - Fax:208-205-0356
Practice Address - Street 1:4400 E FLAMINGO AVE STE 130
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687
Practice Address - Country:US
Practice Address - Phone:208-205-0350
Practice Address - Fax:208-205-0356
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14160207R00000X
IDO-1267207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine