Provider Demographics
NPI:1477581635
Name:LI, XIAOHUA (MD)
Entity Type:Individual
Prefix:
First Name:XIAOHUA
Middle Name:
Last Name:LI
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-1246
Mailing Address - Fax:704-384-6072
Practice Address - Street 1:1900 RANDOLPH RD STE 800
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207
Practice Address - Country:US
Practice Address - Phone:704-384-1246
Practice Address - Fax:704-384-6072
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL219292084P0800X
NC2018-024762084P0800X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009975565Medicaid
AL051502070OtherBLUE CROSS
AL051502070Medicaid
AL051509102OtherBC FEDERAL EHBP
AL111344Medicaid
AL260047086OtherRAILROAD MEDICARE
AL051525249OtherBLUE CROSS
AL125981Medicaid
AL33034555OtherMEDICAID REHAB
AL051109988OtherBLUE CROSS
AL51599176OtherBLUE CROSS
AL111344Medicaid