Healthcare Provider Details

I. General information

NPI: 1083271985
Provider Name (Legal Business Name): KAI-LI LIANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8613 ROUTE 29 STE 101
FAIRFAX VA
22031-2171
US

IV. Provider business mailing address

8613 ROUTE 29 STE 101
FAIRFAX VA
22031-2171
US

V. Phone/Fax

Practice location:
  • Phone: 571-350-8400
  • Fax: 703-208-3108
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-208-3108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD94032
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0101288288
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: