Provider Demographics
NPI:1326012998
Name:QIU, WILLIAM W (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:W
Last Name:QIU
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 1:200 TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-1705
Mailing Address - Country:US
Mailing Address - Phone:609-893-6611
Mailing Address - Fax:
Practice Address - Street 1:200 TRENTON RD
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-1705
Practice Address - Country:US
Practice Address - Phone:609-893-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-04-02
Deactivation Date:2023-03-27
Deactivation Code:
Reactivation Date:2023-05-02
Provider Licenses
StateLicense IDTaxonomies
NY2283772085R0202X
NJ25MA075518002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0060917Medicaid
NJP00232994Medicare PIN
NJ088714RRDMedicare PIN
NJ0060917Medicaid