Provider Demographics
NPI:1720081375
Name:QURESHI, FAROOQ HUSSAIN (MD)
Entity type:Individual
Prefix:DR
First Name:FAROOQ
Middle Name:HUSSAIN
Last Name:QURESHI
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 1:715 S DOCTORS DR
Mailing Address - Street 2:STE F
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-7113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:715 S DOCTORS DR
Practice Address - Street 2:STE F
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-7113
Practice Address - Country:US
Practice Address - Phone:843-537-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7952207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC079523Medicaid
SCP00338342OtherRR MEDICARE
SCP00338342OtherRR MEDICARE
SC$$$$$$$$$OtherBCBS
B91478Medicare UPIN