Provider Demographics
NPI:1306374483
Name:QAMRUDDIN, ASMA (MD)
Entity Type:Individual
Prefix:DR
First Name:ASMA
Middle Name:
Last Name:QAMRUDDIN
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 1:30W221 MEADE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1115
Mailing Address - Country:US
Mailing Address - Phone:847-766-7480
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO # 105550
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-1143
Practice Address - Country:US
Practice Address - Phone:505-272-1443
Practice Address - Fax:505-272-5958
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0753512080N0001X
NMS2017-05402083P0901X
NMXYZ2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty