MEDICARE: JINGJING XU L,AC

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	171100000X	Acupuncturist	U03076	MD

General Provider Information

NPI Number	:	1629837562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JINGJING XU L,AC

Provider Business Mailing Address
First Line	:	1909 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	443-979-3668
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	443-805-4755
Fax Number	:

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

Provider Enumeration Date	:	03/14/2024
Last Update Date	:	09/25/2024

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