Healthcare Provider Details

I. General information

NPI: 1902034689
Provider Name (Legal Business Name): YAN-HUA KATY LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9759 MANCHESTER ROAD
ROCK HILL MO
63119
US

IV. Provider business mailing address

9759 MANCHESTER ROAD
ROCK HILL MO
63119
US

V. Phone/Fax

Practice location:
  • Phone: 314-781-4922
  • Fax: 314-645-0158
Mailing address:
  • Phone: 314-781-4922
  • Fax: 314-645-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2015004070
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: