Provider Demographics
NPI:1679735351
Name:LIU, AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
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 1:2003 LOWER STATE RD
Mailing Address - Street 2:BUILDING 200
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2603
Mailing Address - Country:US
Mailing Address - Phone:215-345-6647
Mailing Address - Fax:
Practice Address - Street 1:2003 LOWER STATE RD
Practice Address - Street 2:BUILDING 200
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2603
Practice Address - Country:US
Practice Address - Phone:215-345-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2015-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01437207R00000X
MI4301095221207N00000X
NJ25MA09145600207N00000X
PAMD448908207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine