Physician Compare National (NPI:1508203514)

HEALTHCARE PROVIDER: MARK LIAO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508203514
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173835089
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180526000036
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIAO
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Middle Name	Y
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5799755864
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	513
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1606 N 7TH ST
	Group Practice or individual's line 1 address
City	TERRE HAUTE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	478042706
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8122387523
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ESKENAZI HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150056
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INDIANA UNIVERSITY HEALTH METHODIST HOSPITAL (INDIANAPOLIS)
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y