Provider Demographics
NPI:1972881050
Name:XU, THOMAS (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TAO
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:372 DANBURY RD STE 197
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2523
Mailing Address - Country:US
Mailing Address - Phone:203-276-3366
Mailing Address - Fax:203-276-3367
Practice Address - Street 1:372 DANBURY RD STE 197
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2523
Practice Address - Country:US
Practice Address - Phone:203-276-3366
Practice Address - Fax:203-276-3367
Is Sole Proprietor?:No
Enumeration Date:2011-07-24
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT053419207R00000X
NY275273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine