Healthcare Provider Details

I. General information

NPI: 1245325752
Provider Name (Legal Business Name): CHUNG YUEN LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: C Y LIU MD

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 GUNBARREL RD
CHATTANOOGA TN
37421
US

IV. Provider business mailing address

1604 GUNBARREL RD
CHATTANOOGA TN
37421
US

V. Phone/Fax

Practice location:
  • Phone: 423-899-6511
  • Fax: 423-899-1160
Mailing address:
  • Phone: 423-899-6511
  • Fax: 423-899-1160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD0000009891
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: