Provider Demographics
NPI:1215932298
Name:QUENG, JOAN AIMEE (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:AIMEE
Last Name:QUENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 TALLULAH RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-8500
Mailing Address - Country:US
Mailing Address - Phone:828-479-6434
Mailing Address - Fax:828-479-2917
Practice Address - Street 1:409 TALLULAH RD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771-8500
Practice Address - Country:US
Practice Address - Phone:828-479-6434
Practice Address - Fax:828-479-2917
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2010-08-05
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
NC9701552207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH26625Medicare UPIN
NC2281324BMedicare ID - Type Unspecified