Individual provider Active NPI

Virgie U Que, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Port Clinton, OH
National Provider Identifier
1629253323
Registry record updated Jan 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
35053050 Issued in OH
Practice address
1790 N Lakewood Ave
Port Clinton, OH 43452-2971
Phone
(419) 734-4539
Fax
(419) 734-6365
NPI assigned
Jan 1, 2008
Last updated
Jan 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 35053050 OH Primary

Addresses

Primary practice location

1790 N Lakewood Ave
Port Clinton, OH 43452-2971

Mailing address

1790 N Lakewood Ave
Port Clinton, OH 43452-2971
Phone (419) 734-4539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35053050OHMDAdolescent Medicine (Internal Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199145600000",
    "number": "1629253323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 N LAKEWOOD AVE",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522971",
            "telephone_number": "419-734-4539",
            "fax_number": "419-734-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 N LAKEWOOD AVE",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522971",
            "telephone_number": "419-734-4539",
            "fax_number": "419-734-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUE",
        "first_name": "VIRGIE",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-01",
        "last_updated": "2008-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35053050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.