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General NPI Number Information
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NPI Number | 1588195481
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Entity Type | Organization
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Legal Business Name | QLER SOLUTIONS LLC
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 300 S PRESTON ST
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City | RANSON
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State | WV
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Zip | 25438-1631
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Country | US
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Telephone | 304-728-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 CAMPUS COMMONS DR SUITE 100
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City | RESTON
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State | VA
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Zip | 20191-1561
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | MS. SUZANNE FORT
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Credential |
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Telephone | 910-523-1052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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