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NPI Code Detail

MEDICARE: DR. LIAWATY HO MD

MEDICARE: DR. LIAWATY HO 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
1207RH0003XHematology & Oncology Physician12865NV

General Provider Information

NPI Number : 1558576686
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LIAWATY HO MD
Provider Business Mailing Address
First Line : 400 N STEPHANIE ST STE 300
Second Line :
City : HENDERSON
State : NV
Zip : 89014-6692
Country : US
Telephone Number : 702-952-3350
Fax Number : 702-952-3364
Provider Business Practice Location Address
First Line : 3730 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3321
Country : US
Telephone Number : 702-952-3400
Fax Number : 702-952-3461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 02/29/2024

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