Provider Demographics
NPI:1952563140
Name:MIAO, XIN (DC)
Entity Type:Individual
Prefix:
First Name:XIN
Middle Name:
Last Name:MIAO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12404 FALCONBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3477
Mailing Address - Country:US
Mailing Address - Phone:301-455-3236
Mailing Address - Fax:
Practice Address - Street 1:2730 UNIVERSITY BLVD W
Practice Address - Street 2:704
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1905
Practice Address - Country:US
Practice Address - Phone:301-585-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01771171100000X
MD03616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist