Provider Demographics
NPI:1437357423
Name:XIA, TIAN (MD)
Entity Type:Individual
Prefix:
First Name:TIAN
Middle Name:
Last Name:XIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 NORTHWATER WAY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2485
Mailing Address - Country:US
Mailing Address - Phone:770-840-8581
Mailing Address - Fax:770-840-0641
Practice Address - Street 1:175 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2153
Practice Address - Country:US
Practice Address - Phone:770-868-1144
Practice Address - Fax:770-868-1276
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3045207P00000X
VA116019066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine