Provider Demographics
NPI:1023017720
Name:QURESHI, AZEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:AZEEM
Middle Name:
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 WYANDOTTE WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8661
Mailing Address - Country:US
Mailing Address - Phone:614-257-5339
Mailing Address - Fax:614-257-5418
Practice Address - Street 1:4425 WYANDOTTE WOODS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8661
Practice Address - Country:US
Practice Address - Phone:614-257-5339
Practice Address - Fax:614-257-5418
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0763742084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000324037OtherANTHEM
OH2284700Medicaid
OHH50638Medicare UPIN
OH000000324037OtherANTHEM