MEDICARE: HAIYANG LI PH.D., L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	U-354	MD

General Provider Information

NPI Number	:	1144399916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAIYANG LI PH.D., L.AC.

Provider Business Mailing Address
First Line	:	1909 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	410-252-1958
Fax Number	:	410-252-2980

Provider Business Practice Location Address
First Line	:	1909 YORK RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-4224
Country	:	US
Telephone Number	:	410-252-1958
Fax Number	:	410-252-2980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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