Qin, Kenan

Qin, Kenan is an individual health care provider with primary practice located at 1160 Joliet St Suite 103, Dyer IN 46311-2096. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Endocrinology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Qin, Kenan can be contacted via phone (219) 322-8534.

Contact Information

Primary practice address
1160 Joliet St Suite 103 Dyer IN 46311-2096
Phone: (219) 322-8534
Fax: (219) 865-9072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 01071421A Indiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01071421A Indiana

Profile Details

NPI number 1679623615
LBN Legal business name Qin, Kenan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated May 5th, 2015 - about 9 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 1679623615 NPPES
Other 32-0149967 GROUP TAX ID
MEDICAID 036106209 GROUP TAX ID

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