Healthcare Provider Details

I. General information

NPI: 1992268759
Provider Name (Legal Business Name): JANA WEI QIAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 WILLARD DAIRY RD STE 203
HIGH POINT NC
27265-8328
US

IV. Provider business mailing address

300 E WENDOVER AVE
GREENSBORO NC
27401-1229
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-3770
  • Fax: 336-884-3771
Mailing address:
  • Phone: 336-663-5205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number2023-01329
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: