Provider Demographics
NPI:1992926307
Name:QUADRI, SYED MOHAMMED (DO)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:MOHAMMED
Last Name:QUADRI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10176 W 400 N
Mailing Address - Street 2:STE B
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9009
Mailing Address - Country:US
Mailing Address - Phone:219-809-9839
Mailing Address - Fax:219-809-9841
Practice Address - Street 1:10176 W 400 N
Practice Address - Street 2:SUITE B
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9009
Practice Address - Country:US
Practice Address - Phone:219-809-9839
Practice Address - Fax:219-809-9841
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036125924207L00000X, 207LP2900X
IN02004065A207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology