Provider Demographics
NPI:1932951530
Name:QADRI, HISHAM ISHTYAQ
Entity Type:Individual
Prefix:
First Name:HISHAM
Middle Name:ISHTYAQ
Last Name:QADRI
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:GME ADMIN
Mailing Address - Street 2:1200 EAST BROAD STREET, BOX 980257
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5023
Practice Address - Country:US
Practice Address - Phone:804-628-7497
Practice Address - Fax:804-827-1016
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program