Healthcare Provider Details

I. General information

NPI: 1003928623
Provider Name (Legal Business Name): QUANG KIM LE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W MAIN ST
BELLEVUE OH
44811-9088
US

IV. Provider business mailing address

26700 BROOKPARK ROAD EXT SUITE 1
NORTH OLMSTED OH
44070-3124
US

V. Phone/Fax

Practice location:
  • Phone: 419-483-4040
  • Fax:
Mailing address:
  • Phone: 440-716-0800
  • Fax: 440-716-1605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-074958
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.074958
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: