=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497235014
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAO ZHOU LIU M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2018
-----------------------------------------------------
Last Update Date | 06/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 593 EDDY ST - RHODE ISLAND HOSPITAL
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-444-5180
-----------------------------------------------------
Fax | 401-444-6681
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 593 EDDY ST - RHODE ISLAND HOSPITAL
-----------------------------------------------------
City | PROVIDENCE
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-444-5180
-----------------------------------------------------
Fax | 401-444-6681
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | LP04586
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------