Provider Demographics
NPI:1245282508
Name:GUO, XIANG-YANG D (MD)
Entity type:Individual
Prefix:
First Name:XIANG-YANG
Middle Name:D
Last Name:GUO
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 1:90 TER HEUN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2533
Mailing Address - Country:US
Mailing Address - Phone:508-495-7160
Mailing Address - Fax:508-495-7152
Practice Address - Street 1:90 TER HEUN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2533
Practice Address - Country:US
Practice Address - Phone:508-495-7160
Practice Address - Fax:508-495-7152
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA219396207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ28862OtherBCBS
MA2106132Medicaid
MASX3487OtherMEDICARE PTAN
MAAA37710OtherHPHC
I33474Medicare UPIN
A38706Medicare ID - Type Unspecified