Basic Information
| Provider Information | |||||||||
| NPI: | 1821197526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | QURESHI | ||||||||
| FirstName: | MAHPARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BURNEY | ||||||||
| OtherFirstName: | MAHPARA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 E MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172682353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177654000 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 01/05/2010 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD430393 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD000000 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1017851840001 | 05 | PA | MEDICAID | 1440989 | 01 | PA | AETNA HMO | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | G920-0055/25RXCU | 01 | PA | CAREFIRST | OTHER | P00390472 | 01 | PA | RAILROAD MEDICARE | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 704662 | 01 | PA | HEALTH AMERICA | OTHER | 2164408 | 01 | PA | MAMSI | OTHER | 120420407 | 01 | PA | DEPT OF LABOR | OTHER | 262481 | 01 | PA | UNISON | OTHER | 50060236 | 01 | PA | CAPITAL BLUECROSS | OTHER | FQ0081430 | 01 | PA | DEA | OTHER | MD430393 | 01 | PA | LICENSE | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 5741339 | 01 | PA | FIRST HEALTH | OTHER | 1561902 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER | 7916926 | 01 | PA | AETNA NON-HMO | OTHER | QU1917297 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |