Provider Demographics
NPI:1407079973
Name:LIU, MARIANNE SHUCHIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIANNE
Middle Name:SHUCHIN
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13819 HANSON BLVD. NW
Mailing Address - Street 2:FAIR VIEW CLINIC
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304
Mailing Address - Country:US
Mailing Address - Phone:763-862-4477
Mailing Address - Fax:319-272-2107
Practice Address - Street 1:13819 HANSON BLVD. NW
Practice Address - Street 2:FAIR VIEW CLINIC
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304
Practice Address - Country:US
Practice Address - Phone:763-862-4477
Practice Address - Fax:319-272-2107
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAIOWA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine