Healthcare Provider Details

I. General information

NPI: 1376726521
Provider Name (Legal Business Name): HAMID R QURAISHI MD & SHANNAZ H QURAISHI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6196 OXON HILL RD SUITE 430
OXON HILL MD
20745-3100
US

IV. Provider business mailing address

6196 OXON HILL RD SUITE 430
OXON HILL MD
20745-3100
US

V. Phone/Fax

Practice location:
  • Phone: 301-567-7200
  • Fax: 301-567-2728
Mailing address:
  • Phone: 301-567-7200
  • Fax: 301-567-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0002868
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR119098
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0014835
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0014135
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD0039416
License Number StateMD

VIII. Authorized Official

Name: MRS. DOROTHY THORNLEY
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-567-7200