Organization
PEDIATRIC GASTROENTEROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMAD AZIM QURESHI MD (MEDICAL DIRECTOR)
(717) 220-4221
Entity
Organization
Contact information
Practice address
11 SPRINT DR STE B, CARLISLE, PA 17015-7789
(717) 422-5546
(171) 422-5589
Mailing address
11 SPRINT DR STE B, CARLISLE, PA 17015-7789
(717) 422-5546
(171) 422-5589
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
MD-423954
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010342670001
—
PA
Enumeration date
05/11/2010
Last updated
07/21/2022
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