Healthcare Provider Details

I. General information

NPI: 1770563058
Provider Name (Legal Business Name): SHUWEI LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HITCHCOCK WAY
MANCHESTER NH
03104-4125
US

IV. Provider business mailing address

22 MAIN ST
SALEM NH
03079
US

V. Phone/Fax

Practice location:
  • Phone: 603-695-2500
  • Fax:
Mailing address:
  • Phone: 603-537-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number213702
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12392
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: