Provider Demographics
NPI:1063538619
Name:LIU, SHOU S (DC)
Entity type:Individual
Prefix:DR
First Name:SHOU
Middle Name:S
Last Name:LIU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1722
Mailing Address - Country:US
Mailing Address - Phone:301-439-8000
Mailing Address - Fax:301-439-5030
Practice Address - Street 1:1600 ELTON RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1722
Practice Address - Country:US
Practice Address - Phone:301-439-8000
Practice Address - Fax:301-439-5030
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK408-0001OtherBLUE CHOICE MEMBER NUMBER
MD711028682Medicaid
MD644559-01OtherCAREFIRST OF MD