Provider Demographics
NPI:1346225034
Name:LI, XIAOBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:XIAOBIN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:XIAOBIN
Other - Middle Name:
Other - Last Name:LI-BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 UPLAND TER
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3126
Mailing Address - Country:US
Mailing Address - Phone:215-813-9430
Mailing Address - Fax:610-853-2507
Practice Address - Street 1:2010 W CHESTER PIKE
Practice Address - Street 2:SUITE 407
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2700
Practice Address - Country:US
Practice Address - Phone:610-853-2502
Practice Address - Fax:610-853-2507
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058825L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA857992M8FMedicare ID - Type Unspecified
PAG 25127Medicare UPIN