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General NPI Number Information
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NPI Number | 1467731224
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Entity Type | Organization
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Legal Business Name | RICHMOND CANCER CENTER LLC
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 1050 REID PARKWAY SUITE 120
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City | RICHMOND
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State | IN
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Zip | 47374-1156
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Country | US
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Telephone | 765-983-3245
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Fax | 765-983-3247
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Provider Business Mailing Address
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Address Line | 3333 BISHOPS GATE
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City | RICHMOND
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State | IN
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Zip | 47374-7933
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Country | US
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Telephone | 765-983-3245
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Fax | 765-983-3247
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | XIUSHENG QIN
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Credential | MD
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Telephone | 765-983-3245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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