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NPI Code Detail

MEDICARE: AFFAN QUADRI MD PA

MEDICARE: AFFAN QUADRI MD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1013256767
Entity Type Code : Organization
Provider Name (Legal Business Name) : AFFAN QUADRI MD PA
Provider Business Mailing Address
First Line : 705 FERRIS ST
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-4025
Country : US
Telephone Number : 904-298-2272
Fax Number : 904-298-2282
Provider Business Practice Location Address
First Line : 705 FERRIS ST
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-4025
Country : US
Telephone Number : 904-298-2272
Fax Number : 904-298-2282
Authorized Official
Title or Position : OWNER
Name : DR. AFFAN QUADRI
Credential : MD
Telephone Number : 904-298-2272
Provider Enumeration Date : 01/31/2013
Last Update Date : 06/11/2013

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