Healthcare Provider Details

I. General information

NPI: 1144585944
Provider Name (Legal Business Name): JIHUI QIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2012
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST TUH, DEPARTMENT OF ANATOMIC AND CLINICAL PATHOLOGY
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

3401 N BROAD ST TUH, DEPARTMENT OF ANATOMIC AND CLINICAL PATHOLOGY
PHILADELPHIA PA
19140-5103
US

V. Phone/Fax

Practice location:
  • Phone: 215-707-3923
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMT202608
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: