Basic Information
| Provider Information | |||||||||
| NPI: | 1306194667 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | QURESHI | ||||||||
| FirstName: | FURHAN | ||||||||
| MiddleName: | RASHID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 CORPORATE BLVD | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705083870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008939698 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4455 EDISON LAKES PKWY | ||||||||
| Address2: | |||||||||
| City: | MISHAWAKA | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465451442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5742316134 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2012 | ||||||||
| LastUpdateDate: | 11/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD466277 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 0101260305 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | 0101260305 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME125457 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 076663 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD466277 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 01077558B | IN | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 26519 | WV | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | MD466277 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 103592721 | 05 | PA | MEDICAID | MM935 | 01 | FL | FL MEDICARE | OTHER |