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General NPI Number Information
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NPI Number | 1790572071
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Entity Type | Individual
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Provider Name | XUTONG GUO MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 225 WILLIAMSON ST
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City | ELIZABETH
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State | NJ
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Zip | 07202-3625
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Country | US
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Telephone | 908-994-5000
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Fax | 908-994-5000
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Provider Business Mailing Address
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Address Line | GUANG BO ST WAN GUO CHENG MOMA BUIDLING 3 ROOM 801
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City | TAIYUAN
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State | SHAN XI
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Zip | 030000
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Country | CN
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | $$$$$$$$$
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License Number State | IA
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