Healthcare Provider Details

I. General information

NPI: 1679511158
Provider Name (Legal Business Name): FARRUKH QURESHI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 N ALMA SCHOOL RD SUITE 160
CHANDLER AZ
85224-5941
US

IV. Provider business mailing address

1343 N ALMA SCHOOL RD SUITE 160
CHANDLER AZ
85224-5941
US

V. Phone/Fax

Practice location:
  • Phone: 480-776-2982
  • Fax: 480-917-7309
Mailing address:
  • Phone: 480-963-1853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number16948
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number37827
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: