Organization
QI WAN MD PC
Active
Organization
QI WAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QI WAN MD (OWNER)
(256) 650-0275
Entity
Organization
Contact information
Practice address
333 WHITESPORT DR SW, STE 303, HUNTSVILLE, AL 35801-3455
(256) 650-0275
(256) 881-0468
Mailing address
333 WHITESPORT DR SW, STE 303, HUNTSVILLE, AL 35801-3455
(256) 650-0275
(256) 881-0468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21622
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51519742
BCBS OF AL PROVIDER #
AL
Enumeration date
06/11/2006
Last updated
02/05/2008
Update your record
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