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NPI Code Detail

MEDICARE: XIAOWEI QIAO BOMBARDIER LMLP

MEDICARE: XIAOWEI QIAO BOMBARDIER LMLP
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
1103T00000XPsychologist2583KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417354390
Entity Type Code : Individual
Provider Name (Legal Business Name) : XIAOWEI QIAO BOMBARDIER LMLP
Provider Business Mailing Address
First Line : 6306 HEDGE LANE TER APT 102
Second Line :
City : SHAWNEE
State : KS
Zip : 66226-4818
Country : US
Telephone Number : 785-432-6426
Fax Number :
Provider Business Practice Location Address
First Line : 2708 W 43RD AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-3125
Country : US
Telephone Number : 913-708-8247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2014
Last Update Date : 09/22/2016

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Directions to “ XIAOWEI QIAO BOMBARDIER LMLP” Practice Location

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