Provider Demographics
NPI:1285601815
Name:NAQVI, HAIDER A (MD)
Entity type:Individual
Prefix:
First Name:HAIDER
Middle Name:A
Last Name:NAQVI
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 1:6005 PARK AVE STE 429B
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5211
Mailing Address - Country:US
Mailing Address - Phone:901-546-2223
Mailing Address - Fax:901-546-2224
Practice Address - Street 1:6005 PARK AVE STE 429B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5211
Practice Address - Country:US
Practice Address - Phone:901-546-2223
Practice Address - Fax:901-546-2224
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00121149Medicaid
TN3144568OtherBCBS TN
TN3724095Medicaid
TN3806210Medicaid
MS09016225Medicaid
MS00121149Medicaid
TN3806210Medicaid
TN3724095Medicare ID - Type UnspecifiedGROUP MEDICARE
TN3806214Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE