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General NPI Number Information
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NPI Number | 1609433937
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Entity Type | Organization
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Legal Business Name | GUAN HUA XU MD MEDICAL PLLC
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 13620 38TH AVE STE 6L
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City | FLUSHING
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State | NY
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Zip | 11354-4263
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Country | US
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Telephone | 347-399-0708
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 159TH ST FL 1
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City | FLUSHING
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State | NY
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Zip | 11358-2511
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Country | US
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Telephone | 347-399-8708
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUAN XU
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Credential | MD
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Telephone | 347-399-8708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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