Basic Information
Provider Information
NPI: 1093710535
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QUIGLEY
FirstName: STEVEN
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 12622
Address2:  
City: BELFAST
State: ME
PostalCode: 049154017
CountryCode: US
TelephoneNumber: 4434816469
FaxNumber: 4434816515
Practice Location
Address1: 2001 MEDICAL PARKWAY
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214013280
CountryCode: US
TelephoneNumber: 4434811000
FaxNumber: 4434811360
Other Information
ProviderEnumerationDate: 06/20/2005
LastUpdateDate: 12/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X200301039NCN Allopathic & Osteopathic PhysiciansSurgery 
208600000XD43199MDY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
60715601301 DEPT. OF LABOROTHER
V793001201 CAREFIRSTOTHER
41474720005MD MEDICAID
891345805NC MEDICAID


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