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NPI Code Detail

MEDICARE: QIXIN SUN M.D.

MEDICARE: QIXIN SUN 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
1207R00000XInternal Medicine Physician35-07-4225-SOH

General Provider Information

NPI Number : 1972614196
Entity Type Code : Individual
Provider Name (Legal Business Name) : QIXIN SUN M.D.
Provider Business Mailing Address
First Line : 1180 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-1902
Country : US
Telephone Number : 614-645-5535
Fax Number : 614-645-5546
Provider Business Practice Location Address
First Line : 1180 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-1902
Country : US
Telephone Number : 614-645-5535
Fax Number : 614-645-5546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 10/30/2017

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