Provider Demographics
NPI:1750321360
Name:LIAW, WEN-HAW (MD)
Entity Type:Individual
Prefix:
First Name:WEN-HAW
Middle Name:
Last Name:LIAW
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 1:10 GUM TREE RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2432
Mailing Address - Country:US
Mailing Address - Phone:610-825-5681
Mailing Address - Fax:
Practice Address - Street 1:16TH STREET AND GIRARD AVENUES
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130
Practice Address - Country:US
Practice Address - Phone:215-787-9068
Practice Address - Fax:215-787-9286
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036539L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109010Medicare PIN
C30365Medicare UPIN