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NPI Code Detail

MEDICARE: ZHENGJUN LIU M.D.

MEDICARE: ZHENGJUN LIU M.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
1174400000XSpecialist263305NY
22085R0202XDiagnostic Radiology Physician01073085AIN

General Provider Information

NPI Number : 1972765097
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZHENGJUN LIU M.D.
Provider Business Mailing Address
First Line : PO BOX 8712
Second Line :
City : FORT WAYNE
State : IN
Zip : 46898-8712
Country : US
Telephone Number : 260-969-6200
Fax Number : 206-407-1447
Provider Business Practice Location Address
First Line : 6819 LIMA RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-1145
Country : US
Telephone Number : 260-969-6200
Fax Number : 260-407-1447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 08/23/2013

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