Provider Demographics
NPI:1730665712
Name:FURQUAN, BEENISH (MD)
Entity Type:Individual
Prefix:
First Name:BEENISH
Middle Name:
Last Name:FURQUAN
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 1:400 HIGHLAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-1783
Mailing Address - Country:US
Mailing Address - Phone:978-741-9500
Mailing Address - Fax:978-741-1392
Practice Address - Street 1:400 HIGHLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1783
Practice Address - Country:US
Practice Address - Phone:978-741-9500
Practice Address - Fax:978-741-3927
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA290235207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine