Provider Demographics
NPI:1679507032
Name:QURESHI, ARIF (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIF
Middle Name:
Last Name:QURESHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30819 LA HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-8905
Mailing Address - Country:US
Mailing Address - Phone:225-664-2029
Mailing Address - Fax:225-754-5225
Practice Address - Street 1:30819 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726
Practice Address - Country:US
Practice Address - Phone:225-664-2029
Practice Address - Fax:225-664-9620
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA27057207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56629OtherMEDICARE GROUP ID
LA1048496Medicaid
4J168Medicare ID - Type Unspecified
LA56629OtherMEDICARE GROUP ID