Healthcare Provider Details

I. General information

NPI: 1780378703
Provider Name (Legal Business Name): YUAN LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 EASTON AVE
BETHLEHEM PA
18020-1431
US

IV. Provider business mailing address

4311 EASTON AVE
BETHLEHEM PA
18020-1431
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT228791
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: