Healthcare Provider Details

I. General information

NPI: 1487813622
Provider Name (Legal Business Name): YAO LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 UNIVERSITY AVE
MADISON WI
53705-3644
US

IV. Provider business mailing address

2870 UNIVERSITY AVE STE 102
MADISON WI
53705-3611
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-7171
  • Fax: 608-265-8060
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA121576
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number60728-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: