MEDICARE: CHENGRI XU 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	U02530	MD

General Provider Information

NPI Number	:	1609340553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHENGRI XU L.AC.

Provider Business Mailing Address
First Line	:	3237A CORPORATE CT FL 2
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2247
Country	:	US
Telephone Number	:	646-509-5998
Fax Number	:

Provider Business Practice Location Address
First Line	:	3237A CORPORATE CT FL 2
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2247
Country	:	US
Telephone Number	:	646-509-5998
Fax Number	:

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

Provider Enumeration Date	:	01/14/2019
Last Update Date	:	01/14/2019

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Directions to “ CHENGRI XU L.AC.” Practice Location

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