Healthcare Provider Details

I. General information

NPI: 1518907567
Provider Name (Legal Business Name): JIAN LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S MAIN ST
CROWN POINT IN
46307
US

IV. Provider business mailing address

7 PARKWAY CENTER SUITE 375
PITTSBURGH PA
15220
US

V. Phone/Fax

Practice location:
  • Phone: 219-757-6077
  • Fax: 219-757-6261
Mailing address:
  • Phone: 412-937-5700
  • Fax: 412-937-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01057345A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: