Individual
DR. JOSE ANTONIO QUIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A069266
CA
2080P0206X
Pediatric Gastroenterology Physician
Primary
34770
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A069266
STATE OF CA LICENSURE
CA
Enumeration date
02/28/2006
Last updated
07/05/2012
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