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General NPI Number Information
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NPI Number | 1295931038
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Entity Type | Individual
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Provider Name | WEIGUO VICTOR LI MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/05/2014
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Provider Practice Location Address
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Address Line | 625 CLARK AVE STE 17A
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1438
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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 AVE STE 17A
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1438
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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 |
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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 | 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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