Healthcare Provider Details

I. General information

NPI: 1427373661
Provider Name (Legal Business Name): KE XIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 FREDERICK RD
CATONSVILLE MD
21228-4516
US

IV. Provider business mailing address

910 FREDERICK RD
CATONSVILLE MD
21228-4516
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-1880
  • Fax: 410-646-3623
Mailing address:
  • Phone: 410-644-1880
  • Fax: 410-646-3623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME123553
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberD81011
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: