MEDICARE: ZHAO LIU M.D., PHD.

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	207RN0300X	Nephrology Physician	47006	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	47006	OTHER	AZ	ARIZONA MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942356365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHAO LIU M.D., PHD.

Provider Business Mailing Address
First Line	:	6622 N 91ST AVE
Second Line	:	STE 220
City	:	GLENDALE
State	:	AZ
Zip	:	85305-2569
Country	:	US
Telephone Number	:	602-759-6883
Fax Number	:	602-224-3358

Provider Business Practice Location Address
First Line	:	2501 N STOCKTON HILL RD STE 102
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-4140
Country	:	US
Telephone Number	:	928-681-2772
Fax Number	:	928-681-2833

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	10/05/2021

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