Provider Demographics
NPI:1437546363
Name:QMG2,LLC
Entity Type:Organization
Organization Name:QMG2,LLC
Other - Org Name:DOCTORS EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-256-0646
Mailing Address - Street 1:201 WHITES HILL LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-2177
Mailing Address - Country:US
Mailing Address - Phone:203-256-0646
Mailing Address - Fax:203-292-7026
Practice Address - Street 1:1910 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3543
Practice Address - Country:US
Practice Address - Phone:203-675-1345
Practice Address - Fax:203-292-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038137261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care