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NPI Code Detail

MEDICARE: BAOGANG LIU MD

MEDICARE: BAOGANG 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
12086X0206XSurgical Oncology Physician0101250133VA
2208600000XSurgery Physician0101269649VA
3390200000XStudent in an Organized Health Care Education/Training ProgramNC
4208600000XSurgery Physician2015-02508NC

General Provider Information

NPI Number : 1144481029
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAOGANG LIU MD
Provider Business Mailing Address
First Line : 1177 N ROAD ST
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-3388
Country : US
Telephone Number : 252-337-9440
Fax Number : 252-384-9997
Provider Business Practice Location Address
First Line : 1177 N ROAD ST
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-3388
Country : US
Telephone Number : 252-384-2560
Fax Number : 252-384-9997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2008
Last Update Date : 12/06/2023

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Directions to “ BAOGANG LIU MD” Practice Location

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