MEDICARE: DR. WEI XU M.D.

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	363A00000X	Physician Assistant	1855	MA
2	208100000X	Physical Medicine & Rehabilitation Physician	232915	MA
3	208100000X	Physical Medicine & Rehabilitation Physician	049958	CT

General Provider Information

NPI Number	:	1992841167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WEI XU M.D.

Provider Business Mailing Address
First Line	:	100 WELLS ST
Second Line	:	SUITE 1B
City	:	HARTFORD
State	:	CT
Zip	:	06103-2928
Country	:	US
Telephone Number	:	860-249-4466
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WELLS ST
Second Line	:	SUITE 1B
City	:	HARTFORD
State	:	CT
Zip	:	06103-2928
Country	:	US
Telephone Number	:	860-249-4466
Fax Number	:

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	11/09/2015

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