Provider Demographics
NPI:1063765535
Name:AFFAN QUADRI MD, PA
Entity type:Organization
Organization Name:AFFAN QUADRI MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDULHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-298-2272
Mailing Address - Street 1:3627 WESTOVER RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32003-7105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3627 WESTOVER RD
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32003-7105
Practice Address - Country:US
Practice Address - Phone:904-298-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty