Provider Demographics
NPI:1154323376
Name:GU, MINXIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:MINXIANG
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10012 KENNERLY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2197
Mailing Address - Country:US
Mailing Address - Phone:314-849-6066
Mailing Address - Fax:314-849-4038
Practice Address - Street 1:10012 KENNERLY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-849-6066
Practice Address - Fax:314-849-4038
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO2001014925207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI10670Medicare UPIN