Provider Demographics
NPI:1386173565
Name:LIU, LIN (MD)
Entity type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:LIU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 S WOODS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3406
Mailing Address - Country:US
Mailing Address - Phone:314-205-6736
Mailing Address - Fax:314-576-2319
Practice Address - Street 1:232 S WOODS MILL RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3406
Practice Address - Country:US
Practice Address - Phone:314-205-6736
Practice Address - Fax:314-576-2319
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1386173565208M00000X
OH35.139388207R00000X
MO2017016921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist