Provider Demographics
NPI:1700847720
Name:MU, LIANKE (MD)
Entity Type:Individual
Prefix:DR
First Name:LIANKE
Middle Name:
Last Name:MU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE # 305
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1134
Mailing Address - Country:US
Mailing Address - Phone:256-494-0990
Mailing Address - Fax:256-494-0948
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SUITE # 305
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1134
Practice Address - Country:US
Practice Address - Phone:256-494-0990
Practice Address - Fax:256-494-0948
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00023496207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051510578Medicaid
AL051510578Medicaid
AL051510578Medicare PIN