Provider Demographics
NPI:1740954775
Name:MQ HOLDINGS LLC
Entity type:Organization
Organization Name:MQ HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIAMZON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:702-499-0589
Mailing Address - Street 1:9205 W RUSSELL RD
Mailing Address - Street 2:ST 240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1407
Mailing Address - Country:US
Mailing Address - Phone:702-499-0589
Mailing Address - Fax:
Practice Address - Street 1:9205 W RUSSELL RD
Practice Address - Street 2:ST 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1407
Practice Address - Country:US
Practice Address - Phone:702-499-0589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty