Healthcare Provider Details

I. General information

NPI: 1073615712
Provider Name (Legal Business Name): SHENG LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR MHMC-FAMILY MEDICINE
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

600 W 3RD ST
MANSFIELD OH
44906-2633
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-5731
  • Fax:
Mailing address:
  • Phone: 419-522-6191
  • Fax: 419-525-6723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35078765
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: