Provider Demographics
NPI:1225359052
Name:ZHAO, QIAN
Entity Type:Individual
Prefix:
First Name:QIAN
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 OLD WOLOMOLOPOAG ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2989
Mailing Address - Country:US
Mailing Address - Phone:973-462-2100
Mailing Address - Fax:
Practice Address - Street 1:277 PLEASANT ST.
Practice Address - Street 2:PRIMA CARE, P.C.
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02722-1070
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA254441207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine