Provider Demographics
NPI:1649634528
Name:SU, XIAOWEI WILLIAM (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:XIAOWEI
Middle Name:WILLIAM
Last Name:SU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HOPE DRIVE
Mailing Address - Street 2:MAILCODE EC 037
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2036
Mailing Address - Country:US
Mailing Address - Phone:717-531-3828
Mailing Address - Fax:717-531-0814
Practice Address - Street 1:30 HOPE DR STE 1300
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2036
Practice Address - Country:US
Practice Address - Phone:717-531-3838
Practice Address - Fax:717-531-0814
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4711192084N0400X, 2084N0008X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program