Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | MD426406 | PA |
Y | 208200000X | Surgeon | MD426406 | PA |
Y | 208600000X | Surgeon | MD426406 | PA |
NPI | 1043354616 |
---|---|
Provider Name | Gary S Xiao |
First Address | Philadelphia, PA 19102-1121 |
Second Address | Philadelphia, PA 19102-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101877007 | (05) | PA |