Provider Demographics
NPI:1669567954
Name:QUIN, ERNEST MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:MATTHEW
Last Name:QUIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE D330
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6758
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6701 AIRPORT BLVD STE D330
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6758
Practice Address - Country:US
Practice Address - Phone:251-607-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31161207RC0001X
MS18399207RC0001X
AL33476207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP01240847OtherRAILROAD MEDICARE
MS04453851Medicaid
AL1669567954Medicaid
MS302I063307Medicare PIN
MS333266YKDBMedicare PIN
MS302I067052Medicare PIN
MSP01240847OtherRAILROAD MEDICARE