Provider Demographics
NPI:1942284823
Name:QADRI, ALAM MIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAM
Middle Name:MIAN
Last Name:QADRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1315 CONNECTICUT WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1271
Mailing Address - Country:US
Mailing Address - Phone:330-655-7794
Mailing Address - Fax:330-929-7004
Practice Address - Street 1:1315 CONNECTICUT WOODS DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1271
Practice Address - Country:US
Practice Address - Phone:330-655-7794
Practice Address - Fax:330-929-7004
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036312Q207ZB0001X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0529495Medicaid
OH0529495Medicaid
OHC02636Medicare UPIN