Provider Demographics
NPI:1679504146
Name:MID-SHORE WOMEN'S HEALTH, LLC
Entity Type:Organization
Organization Name:MID-SHORE WOMEN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-822-3246
Mailing Address - Street 1:403 PURDY ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4059
Mailing Address - Country:US
Mailing Address - Phone:410-822-3246
Mailing Address - Fax:410-822-0633
Practice Address - Street 1:403 PURDY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4059
Practice Address - Country:US
Practice Address - Phone:410-822-3246
Practice Address - Fax:410-822-0633
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-SHORE WOMEN'S HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-05
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406043100Medicaid
MD461MIMedicare UPIN