Provider Demographics
NPI:1093794778
Name:QUIGLEY, BRIAN S (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14501 NEW FALLS OF THE NEUSE ROAD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614
Mailing Address - Country:US
Mailing Address - Phone:919-554-0213
Mailing Address - Fax:919-554-2830
Practice Address - Street 1:14501 NEW FALLS OF THE NEUSE ROAD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614
Practice Address - Country:US
Practice Address - Phone:919-554-0213
Practice Address - Fax:919-554-2830
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401307207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
69637OtherBLUE CROSS BLUE SHIELD
69637OtherBLUE CROSS BLUE SHIELD
BQ4230467OtherDEA
NC2207892DMedicare ID - Type Unspecified