Healthcare Provider Details

I. General information

NPI: 1609071554
Provider Name (Legal Business Name): SAQIB N QURESHI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MAIN ST
NORTHBOROUGH MA
01532-1914
US

IV. Provider business mailing address

112 MAIN ST
NORTHBOROUGH MA
01532-1914
US

V. Phone/Fax

Practice location:
  • Phone: 508-393-6655
  • Fax: 508-393-4585
Mailing address:
  • Phone: 508-393-6655
  • Fax: 508-393-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number151997
License Number StateMA

VIII. Authorized Official

Name: DR. SAQIB NASEER QURESHI
Title or Position: PRESIDENT
Credential: MD
Phone: 508-393-6655