Healthcare Provider Details

I. General information

NPI: 1679969596
Provider Name (Legal Business Name): XIAONING YUAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 10/24/2023
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5095
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5095
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number302810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: