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General NPI Number Information
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NPI Number | 1083801773
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Entity Type | Organization
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Legal Business Name | WEIGUO LI, LLC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 625 CLARK AVENUE SUITE 17A
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3065
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Country | US
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Telephone | 610-768-7168
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Fax | 610-768-7169
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Provider Business Mailing Address
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Address Line | 625 CLARK AVENUE SUITE 17A
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3065
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Country | US
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Telephone | 610-768-7168
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Fax | 610-768-7169
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WEIGUO VICTOR LI
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Credential | MD
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Telephone | 610-768-7168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD432040
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License Number State | PA
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