MEDICARE: DR. JAMES KUO-LI 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	207RC0000X	Cardiovascular Disease Physician	200200945	NC
2	207RC0000X	Cardiovascular Disease Physician	23593	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00612430	OTHER	NC	RAILROAD MEDICARE

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
3	133EA	OTHER	NC	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720020977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES KUO-LI LIU MD

Provider Business Mailing Address
First Line	:	PO BOX 472423
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28247-2423
Country	:	US
Telephone Number	:	704-321-2741
Fax Number	:	704-542-9991

Provider Business Practice Location Address
First Line	:	11220 ELM LN STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-0450
Country	:	US
Telephone Number	:	704-321-2741
Fax Number	:	704-542-9991

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	05/29/2024

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