Provider Demographics
NPI:1629291257
Name:NAWAB, QURRAT-UL-AIN (MD)
Entity Type:Individual
Prefix:DR
First Name:QURRAT-UL-AIN
Middle Name:
Last Name:NAWAB
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 1:1700 W TOWNLINE ST
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1054
Mailing Address - Country:US
Mailing Address - Phone:641-782-7091
Mailing Address - Fax:641-782-3830
Practice Address - Street 1:1700 W TOWNLINE ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1054
Practice Address - Country:US
Practice Address - Phone:641-782-2131
Practice Address - Fax:641-782-6425
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008008630207RC0200X, 207RP1001X
IA41906207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1629291257Medicaid
MO1629291257Medicaid
OK200197550AMedicaid
KS200557000BMedicaid
IA1629291257Medicaid