Provider Demographics
NPI:1609957281
Name:QUAN, STUART F (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:F
Last Name:QUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:SUITE 4930
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-7489
Mailing Address - Fax:617-983-2488
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:SUITE 4930
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-983-7489
Practice Address - Fax:617-983-2488
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2015-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ11228207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ221606Medicaid
AZ221606Medicaid
D44373Medicare UPIN