Healthcare Provider Details

I. General information

NPI: 1588778765
Provider Name (Legal Business Name): HONG QU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-2148
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number71906
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME168148
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number084836
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number71906
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: