Provider Demographics
NPI:1245521830
Name:QURESHI, NAIMUDDIN
Entity type:Individual
Prefix:
First Name:NAIMUDDIN
Middle Name:
Last Name:QURESHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W UNIVERSITY DR
Mailing Address - Street 2:130
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1951
Mailing Address - Country:US
Mailing Address - Phone:248-652-1135
Mailing Address - Fax:248-652-0280
Practice Address - Street 1:900 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-3300
Practice Address - Country:US
Practice Address - Phone:248-333-3335
Practice Address - Fax:248-745-2862
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001315225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist