Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 46313 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 46313 | AZ |
NPI | 1902975907 |
---|---|
Provider Name | Dr. Allen Shuyuan Liu |
First Address | Phoenix, AZ 85004-1254 |
Second Address | Phoenix, AZ 85004-1254 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 05/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
709015 | (05) | AZ |
Z154489 | MEDICARE (01) | AZ |