Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 35075842 | OH |
NPI | 1144316126 |
---|---|
Provider Name | Dr. Faisal A Quereshy |
First Address | Medina, OH 44256 |
Second Address | Medina, OH 44256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |