=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538081609
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FENG LIU PHD, DABR
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2026
-----------------------------------------------------
Last Update Date | 07/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MEDICAL CENTER BLVD
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27157-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-713-6517
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MEDICAL CENTER BLVD
-----------------------------------------------------
City | WINSTON SALEM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27157-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-713-6517
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0205X
-----------------------------------------------------
Taxonomy Name | Radiological Physics Physician
-----------------------------------------------------
License Number | P6732
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------