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General NPI Number Information
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NPI Number | 1043354616
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Entity Type | Individual
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Provider Name | GARY S XIAO MD
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 216 N BROAD ST 5TH FL
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-762-3900
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Fax | 215-762-3846
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Provider Business Mailing Address
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Address Line | 230 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1121
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Country | US
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Telephone | 215-255-3828
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Fax | 215-255-3577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | MD426406
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD426406
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License Number State | PA
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