MEDICARE: WU YEN LIU MD

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	207Y00000X	Otolaryngology Physician	D0026605	MD
2	207Y00000X	Otolaryngology Physician	MD12997	DC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	G01431W01	OTHER		MEDICARE PROV ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	06810	OTHER		AMERIGROUP
2	1000301	OTHER		UNITED HEALTHCARE
3	27043	OTHER		EMP HEALTH JOHN HOPKINS P
4	9806936	OTHER		CIGNA
6	0738097	OTHER		AETNA US HEALTHCARE
7	269798	OTHER		ANTHEM BCBS
8	33082001	OTHER	MD	BCBS MD RENDERING
9	J0810001	OTHER	DC	BCBS OF DC
10	013219	OTHER	VA	BCBS
11	0L59W	OTHER	MD	BCBS
12	313708	OTHER		MAMSI ALLIANCE OPT CH MDI
13	4053210	OTHER		AETNA SELECT CHOICE
14	494036	OTHER		NCPPO

General Provider Information

NPI Number	:	1457467268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WU YEN LIU MD

Provider Business Mailing Address
First Line	:	3611 BRANCH AVENUE
Second Line	:	SUITE 305
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1242
Country	:	US
Telephone Number	:	301-423-5540
Fax Number	:	301-423-8491

Provider Business Practice Location Address
First Line	:	3611 BRANCH AVENUE
Second Line	:	SUITE 305
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1242
Country	:	US
Telephone Number	:	301-423-5540
Fax Number	:	301-423-8491

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	07/08/2007

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Directions to “ WU YEN LIU MD” Practice Location

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