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NPI Code Detail

MEDICARE: DR. IHTISHAM QAYUM MD

MEDICARE: DR. IHTISHAM QAYUM MD
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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianME177142FL
2207R00000XInternal Medicine PhysicianME177142FL
3207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianME177142FL

General Provider Information

NPI Number : 1861222648
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IHTISHAM QAYUM MD
Provider Business Mailing Address
First Line : PO BOX 100277
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0277
Country : US
Telephone Number : 352-265-0655
Fax Number : 352-265-1107
Provider Business Practice Location Address
First Line : 1600 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-3003
Country : US
Telephone Number : 352-265-0655
Fax Number : 352-265-1107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2024
Last Update Date : 02/27/2026

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