Healthcare Provider Details

I. General information

NPI: 1891220653
Provider Name (Legal Business Name): QIQI YU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 STEPHEN SITTER AVE
SILVER SPRING MD
20910-1290
US

IV. Provider business mailing address

606 STEPHEN SITTER AVE
SILVER SPRING MD
20910-1290
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-5235
  • Fax:
Mailing address:
  • Phone: 301-319-5235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number70628-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD90825
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: