Healthcare Provider Details

I. General information

NPI: 1548295231
Provider Name (Legal Business Name): FUHAI LI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 3RD ST
MILFORD PA
18337-1304
US

IV. Provider business mailing address

200 3RD ST
MILFORD PA
18337-1304
US

V. Phone/Fax

Practice location:
  • Phone: 570-296-8494
  • Fax: 570-296-8493
Mailing address:
  • Phone: 570-296-8494
  • Fax: 570-296-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD428963
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberMD428963
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084D0003X
TaxonomyDiagnostic Neuroimaging (Psychiatry & Neurology) Physician
License NumberMD428963
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: