Healthcare Provider Details

I. General information

NPI: 1275996035
Provider Name (Legal Business Name): ON YING LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 NAAB RD SUITE 210
INDIANAPOLIS IN
46260-1972
US

IV. Provider business mailing address

8414 NAAB RD SUITE 210
INDIANAPOLIS IN
46260-1972
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-7510
  • Fax: 317-338-7540
Mailing address:
  • Phone: 317-338-2281
  • Fax: 317-338-2851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01083471A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: