Provider Demographics
NPI:1013144302
Name:YU, XIANGDONG (PHD)
Entity Type:Individual
Prefix:
First Name:XIANGDONG
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:SEAN
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2042 WOODDALE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4397
Mailing Address - Country:US
Mailing Address - Phone:651-674-3790
Mailing Address - Fax:612-808-5136
Practice Address - Street 1:2042 WOODDALE DR STE 140
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4397
Practice Address - Country:US
Practice Address - Phone:651-674-3790
Practice Address - Fax:612-808-5136
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist