Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 5901002201 | MI |
Y | 213ES0103X | Foot & Ankle Surgery | 5901002201 | MI |
NPI | 1558588582 |
---|---|
Provider Name | Dr. Shahzad S Qureshi |
First Address | Farmington Hills, MI 48336-5546 |
Second Address | Farmington Hills, MI 48336-5546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 06/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4856319350 | BCBS (01) | MI |