Provider Demographics
NPI:1962608646
Name:QASIM, TARIK (MD)
Entity type:Individual
Prefix:DR
First Name:TARIK
Middle Name:
Last Name:QASIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SW ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1135
Mailing Address - Country:US
Mailing Address - Phone:352-548-6000
Mailing Address - Fax:319-524-9068
Practice Address - Street 1:142 WOODRIDGE RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9165
Practice Address - Country:US
Practice Address - Phone:802-371-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0018485-COMP207R00000X
WAMD00049176207R00000X, 207RG0300X, 207RG0300X
IAMD43877207RG0300X, 207RG0300X
HI13946207R00000X
ND13321207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND81311Medicaid
ND81311Medicaid
WA0290080OtherL&I AND CRIME VICTIMS