Provider Demographics
NPI:1669662540
Name:PATRICK, WILLIAM QUELL JR (CSA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:QUELL
Last Name:PATRICK
Suffix:JR
Gender:M
Credentials:CSA
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Mailing Address - Street 1:1 RESEARCH CT
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3221
Mailing Address - Country:US
Mailing Address - Phone:240-403-4067
Mailing Address - Fax:301-519-8001
Practice Address - Street 1:1 RESEARCH CT
Practice Address - Street 2:SUITE 450
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3221
Practice Address - Country:US
Practice Address - Phone:240-403-4067
Practice Address - Fax:301-519-8001
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2009-06-01
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Provider Licenses
StateLicense IDTaxonomies
DCSA0015363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical