Healthcare Provider Details
I. General information
NPI: 1225482953
Provider Name (Legal Business Name): BILL LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/19/2016
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 W 22ND ST STE 101
SIOUX FALLS SD
57105-1503
US
IV. Provider business mailing address
PO BOX 5074
SIOUX FALLS SD
57117-5074
US
V. Phone/Fax
- Phone: 605-328-0000
- Fax: 605-328-0001
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | 13592 |
| License Number State | SD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: