MEDICARE: DR. ROGER T 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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	21030	IA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	21030	IA
3	207RP1001X	Pulmonary Disease Physician	21030	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IA0104	OTHER	IA	UHC OF THE RIVER VALLEY
2	15615	OTHER	IA	WELLMARK
3	35550	OTHER	IA	MIDLAND'S CHOICE
4	849728	OTHER	IA	UNITED HEALTHCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	73006	OTHER	IA	COVENTRY

General Provider Information

NPI Number	:	1841278595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER T LIU MD

Provider Business Mailing Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 347
City	:	DES MOINES
State	:	IA
Zip	:	50324-7046
Country	:	US
Telephone Number	:	515-224-1777
Fax Number	:	515-222-0226

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 347
City	:	DES MOINES
State	:	IA
Zip	:	50324-7046
Country	:	US
Telephone Number	:	515-224-1777
Fax Number	:	515-222-0226

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	10/19/2013

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Directions to “ DR. ROGER T LIU MD” Practice Location

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