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Mack Yi Qin
Military Health Care Provider in Kittery, Maine
NPI 1780180364

Mack Yi Qin is a Military Health Care Provider based in Kittery, ME. Mack Yi Qin practices in Kittery, ME. The NPI Number for Mack Yi Qin is 1780180364 and holds a License No. (Maine).

The current practice location address for Mack Yi Qin is 1 Ayers Circle, Kittery, ME and can be reached out via phone at 207-438-1828 and via fax at 207-438-2003.

Location: 1 Ayers Circle, Kittery, ME, 03904
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780180364
Provider Name
Mack Yi Qin
Credential
Provider Entity Type
Individual
Gender
Male
Address
1 Ayers Circle, Kittery, ME, 03904
Phone Number
207-438-1828
Fax Number
207-438-2003
Provider Enumeration Date
04/03/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1 Ayers Circle
City
Kittery
State
Maine
Zip
03904
Phone Number
207-438-1828
Fax Number
207-438-2003
person
Provider Business Mailing Address Details
Address
1 Ayers Circle
City
Kittery
State
Maine
Zip
03904
Phone Number
207-438-1828
Fax Number
207-438-2003
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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