Healthcare Provider Details

I. General information

NPI: 1215036348
Provider Name (Legal Business Name): MUHAMMAD Z QURESHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 BERT KOUNS LOOP SUITE 4003
SHREVEPORT LA
71118-3119
US

IV. Provider business mailing address

2510 BERT KOUNS LOOP SUITE 4003
SHREVEPORT LA
71118-3119
US

V. Phone/Fax

Practice location:
  • Phone: 318-212-5665
  • Fax: 318-212-5698
Mailing address:
  • Phone: 318-212-5665
  • Fax: 318-212-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number199993
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMD.204068
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number199993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: