Provider Demographics
NPI:1588801765
Name:WANG, QIAN
Entity Type:Individual
Prefix:DR
First Name:QIAN
Middle Name:
Last Name:WANG
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 1:41-1 QIANFISHAN DONGLU
Mailing Address - Street 2:
Mailing Address - City:JINAN
Mailing Address - State:SHANDONG
Mailing Address - Zip Code:250014
Mailing Address - Country:CN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NO5 EAST CULTURE ROAD
Practice Address - Street 2:
Practice Address - City:JINAN
Practice Address - State:SHANDONG
Practice Address - Zip Code:250014
Practice Address - Country:CN
Practice Address - Phone:11868-266-2658
Practice Address - Fax:11868-266-2658
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ11111207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology