Provider Demographics
NPI:1689808776
Name:LIU, WEIGUO (MD, PH D)
Entity Type:Individual
Prefix:DR
First Name:WEIGUO
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGH ST
Mailing Address - Street 2:BUFFALO GENERAL HOSPITAL, DEPARTMENT OF PATHOLOGY
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1126
Mailing Address - Country:US
Mailing Address - Phone:716-859-2140
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:BUFFALO GENERAL HOSPITAL, DEPARTMENT OF PATHOLOGY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-2140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program