Provider Demographics
NPI:1023579745
Name:QURESHI, ANUM (MD)
Entity Type:Individual
Prefix:
First Name:ANUM
Middle Name:
Last Name:QURESHI
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 1:6565 N CHARLES ST STE 203
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-5805
Mailing Address - Country:US
Mailing Address - Phone:443-849-3760
Mailing Address - Fax:443-849-8138
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-3760
Practice Address - Fax:443-849-8138
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD094072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMDMedicaid