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Individual
JUSTIN RAY QUADE
Active
Individual
JUSTIN RAY QUADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50949
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131006
MEDICA
—
01
—
1366633091
GROUP HEALTH
—
05
—
232178000
—
MN
01
—
69124QU
BCBS OF MN
MN
01
—
P00633163
RAILROAD MEDICARE
—
Enumeration date
08/07/2007
Last updated
12/22/2009
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