Provider Demographics
NPI:1528792991
Name:QUNIQUE MED LLC
Entity type:Organization
Organization Name:QUNIQUE MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GODFRIED
Authorized Official - Middle Name:ASARE
Authorized Official - Last Name:KENAH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:703-213-9005
Mailing Address - Street 1:458 CRAB APPLE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-6860
Mailing Address - Country:US
Mailing Address - Phone:540-391-1387
Mailing Address - Fax:
Practice Address - Street 1:458 CRAB APPLE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6860
Practice Address - Country:US
Practice Address - Phone:540-391-1387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA14982681OtherCAQH