Individual
EVAN QU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
Mailing address
20 CENTRAL AVE, MEDFORD, MA 02155-4024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1019559
MA
207R00000X
Internal Medicine Physician
289075
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2021
Last updated
06/28/2024
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