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NPI Code Detail

MEDICARE: QIHUA FAN M.D.

MEDICARE:   QIHUA  FAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianD88875MD
22084N0400XNeurology Physician0101271557VA

General Provider Information

NPI Number : 1467806687
Entity Type Code : Individual
Provider Name (Legal Business Name) : QIHUA FAN M.D.
Provider Business Mailing Address
First Line : PO BOX 780125
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-0125
Country : US
Telephone Number : 804-922-4844
Fax Number :
Provider Business Practice Location Address
First Line : 11958 W BROAD ST
Second Line :
City : HENRICO
State : VA
Zip : 23233-1007
Country : US
Telephone Number : 804-828-9350
Fax Number : 804-364-6521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2016
Last Update Date : 03/29/2023

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Directions to “ QIHUA FAN M.D.” Practice Location

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