Provider Demographics
NPI:1366718538
Name:DONG, MEI XUE
Entity type:Individual
Prefix:
First Name:MEI
Middle Name:XUE
Last Name:DONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:XUEMEI
Other - Middle Name:
Other - Last Name:DONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:209 HAVERFORD ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1907
Mailing Address - Country:US
Mailing Address - Phone:203-506-1264
Mailing Address - Fax:
Practice Address - Street 1:330 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-680-7050
Practice Address - Fax:203-680-7055
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2018-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT54825207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program