Provider Demographics
NPI:1386788917
Name:N B TUANQUIN, M.D., INC
Entity type:Organization
Organization Name:N B TUANQUIN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NARCISO
Authorized Official - Middle Name:B
Authorized Official - Last Name:TUANQUIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-752-1905
Mailing Address - Street 1:112 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3602
Mailing Address - Country:US
Mailing Address - Phone:304-752-1905
Mailing Address - Fax:304-752-5461
Practice Address - Street 1:112 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3602
Practice Address - Country:US
Practice Address - Phone:304-752-1905
Practice Address - Fax:304-752-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0083564000Medicaid
WVD49395Medicare UPIN
WV0083564000Medicaid