MEDICARE: DR. LIN LIU M.D./PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD448403	PA

General Provider Information

NPI Number	:	1265878722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIN LIU M.D./PH.D.

Provider Business Mailing Address
First Line	:	1161 21ST AVE S
Second Line	:	DEPARTMENT OF PATHOLOGY, MICROBIOLOGY AND IMMUNOLOGY
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2561
Country	:	US
Telephone Number	:	615-343-4882
Fax Number	:	615-343-7023

Provider Business Practice Location Address
First Line	:	1161 21ST AVE S
Second Line	:	DEPARTMENT OF PATHOLOGY, MICROBIOLOGY AND IMMUNOLOGY
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2561
Country	:	US
Telephone Number	:	615-343-4882
Fax Number	:	615-343-7023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2013
Last Update Date	:	05/10/2013

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