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General NPI Number Information
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NPI Number | 1730464041
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Entity Type | Organization
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Legal Business Name | TANVIR I QURESHI MD PC
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 5290 W BROOKSHIRE ST
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City | MONROE
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State | MI
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Zip | 48161-3798
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Country | US
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Telephone | 734-242-5544
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Fax | 734-457-6610
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Provider Business Mailing Address
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Address Line | 5290 W BROOKSHIRE ST
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City | MONROE
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State | MI
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Zip | 48161-3798
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Country | US
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Telephone | 734-242-5544
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Fax | 734-457-6610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TANVIR I QURESHI
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Credential | M.D.P.C.
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Telephone | 734-242-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 042971
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License Number State | MI
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