Provider Demographics
NPI:1982019261
Name:BIAN, QINGNING (MD)
Entity Type:Individual
Prefix:
First Name:QINGNING
Middle Name:
Last Name:BIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-634-5026
Mailing Address - Fax:508-634-5055
Practice Address - Street 1:176 WEST ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2236
Practice Address - Country:US
Practice Address - Phone:508-634-5026
Practice Address - Fax:508-634-5055
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272902207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program