Provider Demographics
NPI:1831270826
Name:QUAN, KARA J (MD)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:J
Last Name:QUAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:125 E BROAD ST STE 305
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6447
Mailing Address - Country:US
Mailing Address - Phone:440-414-9100
Mailing Address - Fax:216-201-5578
Practice Address - Street 1:125 E BROAD ST
Practice Address - Street 2:SUITE 305
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6400
Practice Address - Country:US
Practice Address - Phone:440-414-9100
Practice Address - Fax:216-201-5578
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061794207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2056144Medicaid
OH2056144Medicaid
OHG73874Medicare UPIN