Provider Demographics
NPI:1336133628
Name:GAO-HICKMAN, XIAOMEI (MD)
Entity Type:Individual
Prefix:
First Name:XIAOMEI
Middle Name:
Last Name:GAO-HICKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 EWING CRAWFIS CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9042
Mailing Address - Country:US
Mailing Address - Phone:937-651-6962
Mailing Address - Fax:937-651-6959
Practice Address - Street 1:2160 EWING CRAWFIS CIR
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-9042
Practice Address - Country:US
Practice Address - Phone:937-651-6962
Practice Address - Fax:937-651-6959
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 0812682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57001OtherBCBS
FL201841070OtherTAX ID
FL201841070OtherTAX ID
FL57001OtherBCBS