Provider Demographics
NPI:1790754158
Name:LIANG, MARK J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:LIANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:8800 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3300
Practice Address - Country:US
Practice Address - Phone:704-547-8762
Practice Address - Fax:704-547-1632
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC277042085R0001X
SC141152085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2086561OtherUNITED HEALTHCARE
NC1639267010OtherCIGNA
NC26025OtherPARTNERS
NC8951909Medicaid
NC51909OtherBLUE CROSS
NC62134OtherMEDCOST
SCN27704Medicaid
NC208232FMedicare ID - Type UnspecifiedUNIVERSITY RAD ONC CTR
SCN27704Medicaid
NC1639267010OtherCIGNA
NC2086561OtherUNITED HEALTHCARE
NC208232HMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
NC51909OtherBLUE CROSS
NC208232CMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR