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General NPI Number Information
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NPI Number | 1558300152
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Entity Type | Individual
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Provider Name | XIAOLI MA MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 121 N 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2410
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Country | US
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Telephone | 215-629-8866
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Fax | 215-629-8867
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Provider Business Mailing Address
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Address Line | 405 DARTMOUTH ROAD
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City | BRYN MAWR
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State | PA
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Zip | 19010-0123
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Country | US
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Telephone | 215-629-8866
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Fax | 215-629-8867
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD065188L
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License Number State | PA
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