Provider Demographics
NPI:1558588582
Name:QURESHI, SHAHZAD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHAHZAD
Middle Name:S
Last Name:QURESHI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 MIDDLEBELT RD STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-5546
Mailing Address - Country:US
Mailing Address - Phone:248-545-4110
Mailing Address - Fax:248-545-8582
Practice Address - Street 1:21000 MIDDLEBELT RD STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5546
Practice Address - Country:US
Practice Address - Phone:248-545-4110
Practice Address - Fax:248-545-8582
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002201213EP1101X, 213ES0103X
146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4856319350OtherBCBS
MI4856319350OtherBCBS