Provider Demographics
NPI:1346340379
Name:KASHIF QURESHI MD PC
Entity Type:Organization
Organization Name:KASHIF QURESHI MD PC
Other - Org Name:KASHIF QURESHI MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:HASEEB
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-692-3627
Mailing Address - Street 1:19145 ALLEN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-6812
Mailing Address - Country:US
Mailing Address - Phone:734-692-3627
Mailing Address - Fax:734-692-8214
Practice Address - Street 1:19145 ALLEN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-6812
Practice Address - Country:US
Practice Address - Phone:734-692-3627
Practice Address - Fax:734-692-8214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKQ076251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110H241180OtherBCBS GROUP
MI110H241180OtherBCN GROUP
MI1346340379Medicaid
MIDC2024OtherRAILROAD MEDICARE GROUP
MIH88818Medicare UPIN
MI0N86420Medicare PIN