Healthcare Provider Details

I. General information

NPI: 1215115472
Provider Name (Legal Business Name): ZHENXIANG LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 WEST THAMES STREET UNIT 23
NORWICH CT
06360
US

IV. Provider business mailing address

527 W THAMES ST UNIT 23
NORWICH CT
06360-7153
US

V. Phone/Fax

Practice location:
  • Phone: 203-271-7089
  • Fax:
Mailing address:
  • Phone: 203-271-7089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number48768
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: