Healthcare Provider Details

I. General information

NPI: 1457357758
Provider Name (Legal Business Name): YINONG LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 KINNEYS LN
PORTSMOUTH OH
45662-2806
US

IV. Provider business mailing address

1735 27TH ST STE B06
PORTSMOUTH OH
45662-2681
US

V. Phone/Fax

Practice location:
  • Phone: 740-356-7490
  • Fax: 740-356-7488
Mailing address:
  • Phone: 740-356-8034
  • Fax: 740-353-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number37433
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35-096475
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: