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General NPI Number Information
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NPI Number | 1659407328
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Entity Type | Organization
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Legal Business Name | XIAOLI MA, PC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/23/2011
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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 RD
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City | BRYN MAWR
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State | PA
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Zip | 19010-2123
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Country | US
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Telephone | 484-686-7779
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | XIAOLI MA
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Credential |
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Telephone | 215-629-8866
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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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