Provider Demographics
NPI:1366460701
Name:QURESHI, KASHIF HASEEB (MD)
Entity Type:Individual
Prefix:
First Name:KASHIF
Middle Name:HASEEB
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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 1:3645 WEST RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2225
Practice Address - Country:US
Practice Address - Phone:734-486-4200
Practice Address - Fax:734-486-4202
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076251207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1108227011OtherBCBS
MI708745OtherAETNA
MIP00115405OtherRAILROAD MEDICARE GROUP
MI1108227011OtherBCN IND
MI1366460701Medicaid
1108227011OtherBCBS
H88818Medicare UPIN