Provider Demographics
NPI:1639132012
Name:QURAISHI, SHAHNAZ HAMID (MD)
Entity Type:Individual
Prefix:
First Name:SHAHNAZ
Middle Name:HAMID
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 1:6196 OXON HILL RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3100
Mailing Address - Country:US
Mailing Address - Phone:301-567-1677
Mailing Address - Fax:301-567-2728
Practice Address - Street 1:6196 OXON HILL RD
Practice Address - Street 2:SUITE 430
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3100
Practice Address - Country:US
Practice Address - Phone:301-567-1677
Practice Address - Fax:301-567-2728
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014835170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
D09284Medicare UPIN
MDG02076H76Medicare ID - Type Unspecified