Individual
DR. XOUA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
312 W LAKE ST STE 100, MINNEAPOLIS, MN 55408-4899
(612) 354-7930
(612) 345-5826
Mailing address
1026 7TH ST W, SAINT PAUL, MN 55102-3828
(651) 241-1133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102412
MEDICA
MN
01
—
109414
UCARE MINNESOTA
MN
05
—
655218800
—
MN
01
—
7D714TH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/22/2007
Last updated
04/23/2021
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