Provider Demographics
NPI:1619988177
Name:TAKEI, QUINN AKIRA (DOM)
Entity Type:Individual
Prefix:DR
First Name:QUINN
Middle Name:AKIRA
Last Name:TAKEI
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 SIX FORKS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3072
Mailing Address - Country:US
Mailing Address - Phone:919-848-0200
Mailing Address - Fax:919-848-0211
Practice Address - Street 1:8404 SIX FORKS RD STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3072
Practice Address - Country:US
Practice Address - Phone:919-848-0200
Practice Address - Fax:919-848-0211
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM653171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist