Ai, Quan C

Ai, Quan C is an individual health care provider with primary practice located at 1715 Dousman St , Green Bay WI 54303-3211. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ai, Quan C can be contacted via phone (920) 496-4700.

Contact Information

Primary practice address
1715 Dousman St Green Bay WI 54303-3211
Phone: (920) 496-4700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 45551 Wisconsin

Profile Details

NPI number 1821089616
LBN Legal business name Ai, Quan C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated May 17th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821089616 NPPES
Wisconsin MEDICAID 34414300

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