Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | D64084 | MD |
NPI | 1043282544 |
---|---|
Provider Name | Jia Liu |
First Address | Baltimore, MD 21227-2542 |
Second Address | Columbia, MD 21044-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 07/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
410268100 | (05) | MD |
H90456 | (02) | MD |