Healthcare Provider Details

I. General information

NPI: 1699744425
Provider Name (Legal Business Name): MICHAEL QUAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

IV. Provider business mailing address

275 MARTINE ST SUITE # 301
FALL RIVER MA
02723-1516
US

V. Phone/Fax

Practice location:
  • Phone: 508-675-6591
  • Fax: 508-675-7905
Mailing address:
  • Phone: 508-675-6591
  • Fax: 508-675-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD10577
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: