Provider Demographics
NPI:1932251931
Name:XU, WEI ANNA
Entity Type:Individual
Prefix:DR
First Name:WEI
Middle Name:ANNA
Last Name:XU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 S FREDERICK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1275
Mailing Address - Country:US
Mailing Address - Phone:240-404-6423
Mailing Address - Fax:240-404-6426
Practice Address - Street 1:604 S FREDERICK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1275
Practice Address - Country:US
Practice Address - Phone:240-404-6423
Practice Address - Fax:240-404-6426
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062439173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02217A01Medicare ID - Type Unspecified