Healthcare Provider Details

I. General information

NPI: 1598840225
Provider Name (Legal Business Name): ANDREW LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2761
US

IV. Provider business mailing address

1400 JACKSON ST
DENVER CO
80206-2761
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-270-2174
Mailing address:
  • Phone: 303-388-4461
  • Fax: 303-270-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number28834
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: