# JIE XIE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376923359
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 01083484A | IN | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 01083484A | IN | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 036.156337 | IL | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | 11020054A | IN | — |

## Other

- **Enumeration date:** 06/04/2015
- **Last updated:** 11/21/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1102233913 | ANTHEM PTAN | IN |
| 05 | — | 300062008 | — | IN |