Healthcare Provider Details

I. General information

NPI: 1932165222
Provider Name (Legal Business Name): JULIA J LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOWELL MILL RD NW STE 275
ATLANTA GA
30318-3098
US

IV. Provider business mailing address

720 WESTVIEW DRIVE SW HARRIS BLDG., 100-A
ATLANTA GA
30310
US

V. Phone/Fax

Practice location:
  • Phone: 404-756-1290
  • Fax: 404-756-1490
Mailing address:
  • Phone: 404-756-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number160337
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number87135
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: