Provider Demographics
NPI:1548958572
Name:QASIM, SAHIBZADA MUHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:SAHIBZADA
Middle Name:MUHAMMAD
Last Name:QASIM
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 1:309 JACKSON STREET
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-966-7172
Mailing Address - Fax:318-966-4142
Practice Address - Street 1:ST FRANCIS MEDICAL CENTRE
Practice Address - Street 2:309 JACKSON STREET
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-966-7172
Practice Address - Fax:318-966-4142
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2024-01-02
Deactivation Date:2023-11-30
Deactivation Code:
Reactivation Date:2024-01-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program