MEDICARE: SHAISTA QURESHI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L.5581VP	AL
2	207Q00000X	Family Medicine Physician	2015-02190	NC
3	207Q00000X	Family Medicine Physician	346000	LA

General Provider Information

NPI Number	:	1770681405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAISTA QURESHI MD

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	318-966-4000
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	3608 CONCORDIA ST.
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203
Country	:	US
Telephone Number	:	318-966-8266
Fax Number	:	318-966-8265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	01/27/2026

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Directions to “ SHAISTA QURESHI MD” Practice Location

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