Individual
DR. QURESH Z BANDUKWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
314 SHORTER AVE NW, SUITE100, ROME, GA 30165-4268
(706) 235-5722
(706) 235-5728
Mailing address
314 SHORTER AVE NW, SUITE100, ROME, GA 30165-4268
(706) 235-5722
(706) 235-5728
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
027959
GA
2084P0800X
Psychiatry Physician
Primary
A39105
CA
2084P0804X
Child & Adolescent Psychiatry Physician
027959
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00340458A
—
GA
Enumeration date
01/18/2007
Last updated
09/11/2025
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