Healthcare Provider Details

I. General information

NPI: 1407835853
Provider Name (Legal Business Name): PETER F LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GEORGE MASON DR VIRGINIA HOSPITAL CENTER
ARLINGTON VA
22205
US

IV. Provider business mailing address

1300 PICCARD DR STE 202
ROCKVILLE MD
20850-4303
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-6167
  • Fax: 703-558-5355
Mailing address:
  • Phone: 301-921-7900
  • Fax: 301-921-7915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101231052
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: