Healthcare Provider Details
I. General information
NPI: 1134188840
Provider Name (Legal Business Name): XIANG LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/21/2006
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4755 OGLETOWN STANTON RD DEPARTMENT OF RADIOLOGY
NEWARK DE
19718-2200
US
IV. Provider business mailing address
4755 OGLETOWN STANTON RD DEPARTMENT OF RADIOLOGY
NEWARK DE
19718-2200
US
V. Phone/Fax
- Phone: 302-733-1806
- Fax: 302-733-1808
- Phone: 302-733-1806
- Fax: 302-733-1808
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | C1-0006891 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: