Healthcare Provider Details

I. General information

NPI: 1235109000
Provider Name (Legal Business Name): QING LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CONTINENTAL DR SUITE 406
NEWARK DE
19713-4306
US

IV. Provider business mailing address

111 CONTINENTAL DR SUITE 406
NEWARK DE
19713-4306
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-2630
  • Fax: 302-368-1271
Mailing address:
  • Phone: 302-368-2630
  • Fax: 302-368-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC10007764
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: