Provider Demographics
NPI:1144282443
Name:XU, XIAO MENG (MD)
Entity type:Individual
Prefix:DR
First Name:XIAO
Middle Name:MENG
Last Name:XU
Suffix:
Gender:F
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:PO BOX 52990
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-0048
Mailing Address - Country:US
Mailing Address - Phone:864-223-3600
Mailing Address - Fax:864-223-6054
Practice Address - Street 1:7301 COLLEGE BLVD
Practice Address - Street 2:STE. 110
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1937
Practice Address - Country:US
Practice Address - Phone:913-341-6297
Practice Address - Fax:913-341-6299
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20697207ZP0102X
MO2010005093207ZP0102X
KS0433975207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1144282443Medicaid
KS2006631550AMedicaid
SC206976Medicaid
44311015OtherBCBS-KC
KS2006631550AMedicaid
SC206976Medicaid
SC220027894Medicare PIN
H110971638Medicare PIN
MOG97000002Medicare PIN