Provider Demographics
NPI:1750106506
Name:QIU, SHARON XUEMENG (OD, MS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:XUEMENG
Last Name:QIU
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:DR
Other - First Name:XUEMENG
Other - Middle Name:
Other - Last Name:QIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD, MS
Mailing Address - Street 1:506-247 NORTHFIELD DR E
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N2K0H1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY AVE W
Practice Address - Street 2:UNIVERSITY OF WATERLOO CONTACT LENS CLINIC
Practice Address - City:WATERLOO
Practice Address - State:ONTARIO
Practice Address - Zip Code:N2K0H1
Practice Address - Country:CA
Practice Address - Phone:519-888-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist