Healthcare Provider Details

I. General information

NPI: 1952346256
Provider Name (Legal Business Name): MICHAEL S LIAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 ELMA G MILES PKWY
HINESVILLE GA
31313-4000
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 912-369-9400
  • Fax:
Mailing address:
  • Phone: 866-775-3551
  • Fax: 703-365-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number51849
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2024-01978
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number101199
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101240017
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: