Individual
PEIGUANG TYLER XIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 N RITTER AVE, SUITE 375B, INDIANAPOLIS, IN 46219-3052
(317) 355-9370
(317) 621-5678
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01058468A
IN
208M00000X
Hospitalist Physician
Primary
01058468A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511010
—
IN
01
—
P01148174
RR MEDICARE PTAN
IN
01
—
P01214638
RR MEDICARE PTAN
IN
Enumeration date
02/09/2006
Last updated
12/08/2014
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