Basic Information
Provider Information
NPI: 1578060141
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QURESHI
FirstName: MUHAMMAD
MiddleName: HUMZA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 425 LEWIS HARGETT CIR
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405033590
CountryCode: US
TelephoneNumber: 8592681030
FaxNumber:  
Practice Location
Address1: 800 ROSE STREET ANESTHESIOLOGY
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360001
CountryCode: US
TelephoneNumber: 8592180069
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 04/10/2018
LastUpdateDate: 06/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X56869KYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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