Healthcare Provider Details

I. General information

NPI: 1386551463
Provider Name (Legal Business Name): MUHAMMAD QASIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 CHESTNUT ST
SPRINGFIELD MA
01199-0001
US

IV. Provider business mailing address

190 ATWATER RD
SPRINGFIELD MA
01107-1255
US

V. Phone/Fax

Practice location:
  • Phone: 502-572-5574
  • Fax:
Mailing address:
  • Phone: 502-572-5574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number3021234
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: