Healthcare Provider Details
I. General information
NPI: 1215957899
Provider Name (Legal Business Name): WEI LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8303 ARLINGTON BLVD SUITE 203
FAIRFAX VA
22031-2903
US
IV. Provider business mailing address
8303 ARLINGTON BLVD SUITE 203
FAIRFAX VA
22031-2903
US
V. Phone/Fax
- Phone: 703-208-1998
- Fax: 703-208-1950
- Phone: 703-208-1998
- Fax: 703-208-1950
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101232333 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: