1629344288 NPI number — CENTRAL EXPRESS CLINIC PLLC

Table of content: DR. CHARLES QIMING CUI M.D. (NPI 1356737670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629344288 NPI number — CENTRAL EXPRESS CLINIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL EXPRESS CLINIC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629344288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 W BROOMFIELD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MT PLEASANT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48858-4515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-772-2100
Provider Business Mailing Address Fax Number:
989-772-2103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 COURT ST
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
WEST BRANCH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48661-9390
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-516-4317
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ELKINS
Authorized Official First Name:
MARTY
Authorized Official Middle Name:
Authorized Official Title or Position:
PATIENT ACCOUNT MANAGER
Authorized Official Telephone Number:
98951614317

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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