Provider Demographics
NPI:1023079274
Name:RUAN, XIULU (MD)
Entity type:Individual
Prefix:DR
First Name:XIULU
Middle Name:
Last Name:RUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SPRINGHILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3326
Mailing Address - Country:US
Mailing Address - Phone:251-478-4900
Mailing Address - Fax:251-478-1996
Practice Address - Street 1:2001 SPRINGHILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3326
Practice Address - Country:US
Practice Address - Phone:251-478-4900
Practice Address - Fax:251-478-1996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025262174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH83548Medicare UPIN