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Individual

QINGYU XU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
30 N 1900 E RM 1A071, SALT LAKE CITY, UT 84132-0002
(801) 581-2868
Mailing address
30 N 1900 E RM 1A071, SALT LAKE CITY, UT 84132-0002
(801) 581-2868

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL84120
SC
2085R0202X
Diagnostic Radiology Physician
Primary
12439747-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LL84120
SOUTH CAROLINA LIMITED LICENSE
SC
Enumeration date
05/21/2020
Last updated
09/15/2021
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