Provider Demographics
NPI:1679511158
Name:QURESHI, FARRUKH (MD)
Entity Type:Individual
Prefix:DR
First Name:FARRUKH
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 1:1343 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5941
Mailing Address - Country:US
Mailing Address - Phone:480-963-1853
Mailing Address - Fax:
Practice Address - Street 1:1343 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 160
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5941
Practice Address - Country:US
Practice Address - Phone:480-776-2982
Practice Address - Fax:480-917-7309
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16948174400000X
AZ37827207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ122802Medicaid
AZ122802Medicaid
MS130000193Medicare ID - Type Unspecified
AZ122802Medicaid