Healthcare Provider Details

I. General information

NPI: 1063538619
Provider Name (Legal Business Name): SHOU S LIU D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ELTON RD
SILVER SPRING MD
20903-1722
US

IV. Provider business mailing address

1600 ELTON RD
SILVER SPRING MD
20903-1722
US

V. Phone/Fax

Practice location:
  • Phone: 301-439-8000
  • Fax: 301-439-5030
Mailing address:
  • Phone: 301-439-8000
  • Fax: 301-439-5030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS03407
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: