MEDICARE: DR. SHOAIB QURESHI M.D

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
1	207Q00000X	Family Medicine Physician	41376	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417056250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHOAIB QURESHI M.D

Provider Business Mailing Address
First Line	:	7865 EDUCATORS LANE,
Second Line	:	SUITE 300
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8191
Country	:	US
Telephone Number	:	901-384-9920
Fax Number	:	901-937-7879

Provider Business Practice Location Address
First Line	:	7865 EDUCATORS LANE,
Second Line	:	SUITE 300
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8191
Country	:	US
Telephone Number	:	901-384-9920
Fax Number	:	901-937-7879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2010

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