Provider Demographics
NPI:1639323710
Name:JOSE A. QUIROS MD PA
Entity Type:Organization
Organization Name:JOSE A. QUIROS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUIROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-657-3040
Mailing Address - Street 1:4343 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4416
Mailing Address - Country:US
Mailing Address - Phone:301-657-3040
Mailing Address - Fax:301-718-0459
Practice Address - Street 1:4343 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4416
Practice Address - Country:US
Practice Address - Phone:301-657-3040
Practice Address - Fax:301-718-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-16
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD29256207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty