Provider Demographics
NPI:1548457351
Name:QURESHI, AYESHA MARYAM (DC)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:MARYAM
Last Name:QURESHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 LIVERNOIS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1606
Mailing Address - Country:US
Mailing Address - Phone:248-688-9260
Mailing Address - Fax:248-422-6139
Practice Address - Street 1:2265 LIVERNOIS RD STE 200
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1606
Practice Address - Country:US
Practice Address - Phone:248-688-9260
Practice Address - Fax:248-422-6139
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor