Provider Demographics
NPI:1023191061
Name:QURESHI, ABDUL S (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:S
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 1:549 CENTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757
Mailing Address - Country:US
Mailing Address - Phone:304-822-4561
Mailing Address - Fax:304-822-7809
Practice Address - Street 1:549 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1352
Practice Address - Country:US
Practice Address - Phone:304-822-4561
Practice Address - Fax:304-822-7809
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18333207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0078705000Medicaid
WV0078705000Medicaid
G20372Medicare UPIN