Provider Demographics
NPI:1710074356
Name:GUO, XI (MD)
Entity Type:Individual
Prefix:MS
First Name:XI
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7305 GRAND RIVER RD
Mailing Address - Street 2:STE 550
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7376
Mailing Address - Country:US
Mailing Address - Phone:810-534-5599
Mailing Address - Fax:810-534-5999
Practice Address - Street 1:7305 GRAND RIVER RD
Practice Address - Street 2:STE 550
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7376
Practice Address - Country:US
Practice Address - Phone:810-534-5599
Practice Address - Fax:810-534-5999
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010739712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4606177Medicaid
MI4606177Medicaid
MI0D76012Medicare ID - Type Unspecified
MI0H161440Medicare ID - Type Unspecified