Provider Demographics
NPI:1609162791
Name:LIANG, RALPH
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 BECKLEY RD
Mailing Address - Street 2:T0610
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4189
Mailing Address - Country:US
Mailing Address - Phone:269-979-0778
Mailing Address - Fax:269-979-0778
Practice Address - Street 1:5700 BECKLEY RD
Practice Address - Street 2:T0610
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4189
Practice Address - Country:US
Practice Address - Phone:269-979-0778
Practice Address - Fax:269-979-0778
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist