Healthcare Provider Details

I. General information

NPI: 1588577787
Provider Name (Legal Business Name): LIANG DAVID XIAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 EASTERN AVE
AUGUSTA ME
04330-5951
US

IV. Provider business mailing address

227 EASTERN AVE
AUGUSTA ME
04330-5951
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-3185
  • Fax: 207-622-5697
Mailing address:
  • Phone: 207-622-3185
  • Fax: 207-622-5697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: