Provider Demographics
NPI:1003435900
Name:QURAISHI, JAVAIRIA (MD)
Entity Type:Individual
Prefix:
First Name:JAVAIRIA
Middle Name:
Last Name:QURAISHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S LAKE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6638
Mailing Address - Country:US
Mailing Address - Phone:219-945-4580
Mailing Address - Fax:219-945-4581
Practice Address - Street 1:1500 S LAKE PARK AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6638
Practice Address - Country:US
Practice Address - Phone:219-945-4580
Practice Address - Fax:219-945-4581
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01091567A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine