MEDICARE: DR. AMY G LIU O.D.

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
1	152W00000X	Optometrist	5633	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467566307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY G LIU O.D.

Provider Business Mailing Address
First Line	:	367 E JENKINS AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3016
Country	:	US
Telephone Number	:	614-476-2086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/25/2024

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