Provider Demographics
NPI:1588386551
Name:XU, JEFFREY WILLIAM (LAC, MBBS)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:WILLIAM
Last Name:XU
Suffix:
Gender:M
Credentials:LAC, MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 EGGERT DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-4211
Mailing Address - Country:US
Mailing Address - Phone:240-449-9412
Mailing Address - Fax:
Practice Address - Street 1:5411 W CEDAR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1516
Practice Address - Country:US
Practice Address - Phone:301-530-7331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02948171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist