MEDICARE: PEGGY LIAO 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	207N00000X	Dermatology Physician	43533	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	016756	OTHER	CO	KAISER COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1699799379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY LIAO MD

Provider Business Mailing Address
First Line	:	PO BOX 3770
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-1440
Country	:	US
Telephone Number	:	303-805-7686
Fax Number	:	303-805-7732

Provider Business Practice Location Address
First Line	:	2200 E 18TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1205
Country	:	US
Telephone Number	:	303-322-7789
Fax Number	:	303-805-7732

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	12/02/2011

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Directions to “ PEGGY LIAO MD” Practice Location

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