Healthcare Provider Details

I. General information

NPI: 1487856175
Provider Name (Legal Business Name): MARIAN LIU DEL VECCHIO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 ERIN COURT
HILLSBORO OH
45133
US

IV. Provider business mailing address

6393 HAMILTON RD
LIBERTY TOWNSHIP OH
45044-9342
US

V. Phone/Fax

Practice location:
  • Phone: 937-393-5781
  • Fax: 937-393-5784
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35.095820
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-095820
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: