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General NPI Number Information
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NPI Number | 1972656650
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Entity Type | Individual
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Provider Name | YAOHUI GLORIA XU M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 1 S. PARK STREET, 7TH FLOOR
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City | MADISON
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State | WI
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Zip | 53715
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Country | US
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Telephone | 608-287-2620
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Fax | 608-287-2676
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Provider Business Mailing Address
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Address Line | 5511 GRASSLAND TRL
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City | MIDDLETON
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State | WI
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Zip | 53562-5262
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Country | US
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Telephone | 608-831-1346
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Fax | 608-287-2676
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 50249
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License Number State | WI
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