Provider Demographics
NPI:1629070842
Name:QURAISHI, AMBEREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBEREEN
Middle Name:
Last Name:QURAISHI
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 1:1838 GREENE TREE RD STE 535
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7104
Mailing Address - Country:US
Mailing Address - Phone:410-469-4000
Mailing Address - Fax:410-469-4074
Practice Address - Street 1:1838 GREENE TREE RD
Practice Address - Street 2:SUITE 535
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-6391
Practice Address - Country:US
Practice Address - Phone:410-469-4000
Practice Address - Fax:410-469-4074
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222766207R00000X
MDD0067367207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2094193Medicaid
MA2094193Medicaid
MAA37980Medicare ID - Type Unspecified
MAI23010Medicare UPIN