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General NPI Number Information
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NPI Number | 1326783226
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Entity Type | Organization
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Legal Business Name | EUDOC PLLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 1520 HUGUENOT RD STE 114
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-2477
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Country | US
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Telephone | 804-372-3461
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Fax |
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Provider Business Mailing Address
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Address Line | 14364 ALTAVISTA BLVD
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City | MIDLOTHIAN
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State | VA
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Zip | 23114-6832
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Country | US
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Telephone | 703-321-6386
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH DENG QIU
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Credential | MD
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Telephone | 804-362-7307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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