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Organization

ADVANCED DIABETES AND ENDOCRINE CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAISTA A QUDDUSI M.D. (PRESIDENT)
(253) 880-1029
Entity
Organization

Contact information

Practice address
700 S 320TH ST, SUITE D, FEDERAL WAY, WA 98003-4691
(253) 880-1029
(253) 322-6203
Mailing address
700 S 320TH ST, SUITE D, FEDERAL WAY, WA 98003-4691
(253) 880-1029
(253) 322-6203

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00032808
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00181501
RAILROAD
WA
Enumeration date
07/30/2014
Last updated
11/24/2014
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