Provider Demographics
NPI:1386952380
Name:CHI-CHIOU LIU MD PA
Entity type:Organization
Organization Name:CHI-CHIOU LIU MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHI CHIOU
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-466-0200
Mailing Address - Street 1:1102 COLONNADES DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34949-3063
Mailing Address - Country:US
Mailing Address - Phone:772-466-0200
Mailing Address - Fax:772-466-2730
Practice Address - Street 1:1102 COLONNADES DR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34949-3063
Practice Address - Country:US
Practice Address - Phone:772-466-0200
Practice Address - Fax:772-466-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty