Individual
DR. IHTISHAM QAYUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0655
(352) 265-1107
Mailing address
PO BOX 100277, GAINESVILLE, FL 32610-0277
(352) 265-0655
(352) 265-1107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME177142
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
BP10086880
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME177142
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
ME177142
FL
Other
Enumeration date
08/06/2024
Last updated
02/27/2026
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