Provider Demographics
NPI:1851362990
Name:LIU, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 PAULS RD
Mailing Address - Street 2:
Mailing Address - City:POINT ROBERTS
Mailing Address - State:WA
Mailing Address - Zip Code:98281-8817
Mailing Address - Country:US
Mailing Address - Phone:509-981-8484
Mailing Address - Fax:
Practice Address - Street 1:631 PAULS RD
Practice Address - Street 2:
Practice Address - City:POINT ROBERTS
Practice Address - State:WA
Practice Address - Zip Code:98281-8817
Practice Address - Country:US
Practice Address - Phone:509-981-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2025-11-14
Deactivation Date:2014-07-01
Deactivation Code:
Reactivation Date:2025-11-14
Provider Licenses
StateLicense IDTaxonomies
CAC534372085R0204X, 174400000X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C534370Medicaid
CABE494ZMedicare PIN
CA00C534370Medicaid
CABE494ZMedicare PIN
CA00C534370Medicaid