Provider Demographics
NPI:1043263494
Name:ALAM, TAUQUEER S (MD)
Entity Type:Individual
Prefix:
First Name:TAUQUEER
Middle Name:S
Last Name:ALAM
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:PO BOX 8037
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-0001
Mailing Address - Country:US
Mailing Address - Phone:864-885-0058
Mailing Address - Fax:864-885-0098
Practice Address - Street 1:109 CARTER PARK DR
Practice Address - Street 2:SUITE 3A
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1152
Practice Address - Country:US
Practice Address - Phone:864-885-0058
Practice Address - Fax:864-885-0098
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG29925Medicare UPIN