Healthcare Provider Details

I. General information

NPI: 1588407126
Provider Name (Legal Business Name): MUHAMMAD ABDULWAHEED QUADRI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N SAGINAW ST
FLINT MI
48505-4452
US

IV. Provider business mailing address

1331 STANDARD AVE
ELMONT NY
11003-3348
US

V. Phone/Fax

Practice location:
  • Phone: 810-406-4246
  • Fax:
Mailing address:
  • Phone: 516-737-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: