MEDICARE: XIN LI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1366076713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XIN LI

Provider Business Mailing Address
First Line	:	5500 KNOLL NORTH DR STE 200
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2362
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 KNOLL NORTH DR STE 200
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2362
Country	:	US
Telephone Number	:	443-367-4280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	02/25/2020

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Directions to “ XIN LI ” Practice Location

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