Individual
JUSTIN RAY QUADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 529-9120
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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