| Doctor Name: | EBENEZER KHURAM QURESHI |
| NPI Number: | 1013947381 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 3253 |
| Business Practice Address: | 15351 W Bell Rd Surprise, AZ - 853744580 |
| Business Phone Number: | 8778095092 |
| Business Fax Number: | |
| Mailing Address: | 15351 W Bell Rd, SURPRISE |
| State: | AZ |
| Postal Code: | 853744580 |
| Phone Number: | 8778095092 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 12/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 3253 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |