Individual
SAMUEL A. MCQUISTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, MOBILE, AL 36617-2238
(251) 471-7150
(251) 471-7008
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 471-7150
(251) 471-7008
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24854
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932016
—
AL
05
—
009932017
—
AL
05
—
07134073
—
MS
01
—
17-10678
UNITED HEALTH CARE
AL
05
—
1722219
—
LA
05
—
274819300
—
FL
01
—
51529665
BLUE CROSS
AL
01
—
51529668
BCBS - 575 STANTON RD
AL
01
—
51533229
BLUE CROSS
AL
01
—
51590613
BCBS - 1700 CENTER ST
AL
01
—
51593343
BCBS - 1504 SPRINGHILL AVE
AL
01
—
P00244978
RAILROAD MEDICARE PTAN
AL
Enumeration date
05/19/2006
Last updated
05/06/2015
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