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NPI Code Detail

MEDICARE: DR. SUSAN J LIU MD

MEDICARE: DR. SUSAN J LIU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistD0063453MD

General Provider Information

NPI Number : 1033169594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN J LIU MD
Provider Business Mailing Address
First Line : 3570 SAINT JOHNS LN
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-4020
Country : US
Telephone Number : 410-461-9500
Fax Number : 410-461-8945
Provider Business Practice Location Address
First Line : 3570 SAINT JOHNS LN
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-4020
Country : US
Telephone Number : 410-461-9500
Fax Number : 410-461-8945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/09/2007

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