Provider Demographics
NPI:1912008897
Name:CAO, QING J (MD)
Entity Type:Individual
Prefix:
First Name:QING
Middle Name:J
Last Name:CAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1000
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:424 S 56TH ST STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2177
Practice Address - Country:US
Practice Address - Phone:602-685-5166
Practice Address - Fax:480-478-8091
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA213031207ZP0101X
AZ72308207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH60497Medicare UPIN