Healthcare Provider Details
I. General information
NPI: 1871662205
Provider Name (Legal Business Name): MEI XIA OMD, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10814 HICKORY RIDGE RD
COLUMBIA MD
21044-3622
US
IV. Provider business mailing address
4571 ROLLING MDWS
ELLICOTT CITY MD
21043-6557
US
V. Phone/Fax
- Phone: 410-299-9666
- Fax: 410-465-5289
- Phone: 410-299-9666
- Fax: 410-465-5289
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | U01459 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: