Provider Demographics
NPI:1386047520
Name:QURESHI, SAADIA (MD)
Entity type:Individual
Prefix:
First Name:SAADIA
Middle Name:
Last Name:QURESHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 W LINCOLN TRAIL BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2671
Mailing Address - Country:US
Mailing Address - Phone:270-351-3515
Mailing Address - Fax:270-351-7506
Practice Address - Street 1:800W LINCOLN TRAIL BLVD 102
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-2671
Practice Address - Country:US
Practice Address - Phone:270-351-3515
Practice Address - Fax:270-351-7506
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY42993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100310080Medicaid
KYK164961Medicare PIN