Provider Demographics
NPI:1699776641
Name:GUO, XIAOQING (MD)
Entity type:Individual
Prefix:
First Name:XIAOQING
Middle Name:
Last Name:GUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 HAW CREEK CIR
Mailing Address - Street 2:SUITE 703
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6577
Mailing Address - Country:US
Mailing Address - Phone:770-781-1560
Mailing Address - Fax:770-781-1561
Practice Address - Street 1:1465 HAW CREEK CIR
Practice Address - Street 2:SUITE 703
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6577
Practice Address - Country:US
Practice Address - Phone:770-781-1560
Practice Address - Fax:770-781-1561
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA403909416BMedicaid
H82221Medicare UPIN
GA403909416BMedicaid