Provider Demographics
NPI:1710205398
Name:QURAISHI, MOHAMMED IMRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:IMRAN
Last Name:QURAISHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:975 E 3RD ST # 376
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-7234
Mailing Address - Fax:423-778-6261
Practice Address - Street 1:975 E 3RD ST # 376
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-778-7234
Practice Address - Fax:423-778-6261
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN544562085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology