Provider Demographics
NPI:1700999885
Name:QADEER, ADNAN (MD)
Entity type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:
Last Name:QADEER
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 1:205 BUXTON CT
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-7009
Mailing Address - Country:US
Mailing Address - Phone:319-331-2155
Mailing Address - Fax:
Practice Address - Street 1:975 W FARIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4241
Practice Address - Country:US
Practice Address - Phone:864-729-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD29420208000000X
SC29420208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC294201Medicaid
SCSC36213641Medicare PIN