Provider Demographics
NPI:1821098328
Name:LIU, XU-JING (MD)
Entity Type:Individual
Prefix:
First Name:XU-JING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 96TH ST # 520
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8333 NAAB RD STE 400
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1992
Practice Address - Country:US
Practice Address - Phone:317-338-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419032207R00000X, 208M00000X
IN01074366A208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201292790Medicaid
PA25-1716306OtherINFORMED
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherGREATWEST
PA2983776OtherAETNA HMO
PA50087507OtherCAPITAL BLUECROSS
PA392219OtherUNISON-WMG
PA001930783 0003Medicaid
PA1542504OtherGATEWAY
MD951671OtherCAREFIRST MDBCBS-WMG
PA30131981OtherAMERIHEALTH MERCY - WMG
PA50045002OtherCAPITAL BLUECROSS
PA30080198OtherAMERIHEALTHY MERCY-WMG
PA1424256OtherHIGHMARK BLUE SHIELD-WMG
PA25-1716306OtherDEVON
PA415292OtherUMPC-WMG
MD620266OtherCAREFIRST MD BCBS-WMG
PA7392409OtherAETNA NON-HMO
PAG920-0004/KDM4POOtherCAREFIRST
PAMD419032OtherLICENSE
MD035938600Medicaid
PA2066595OtherFIRST HEALTH
PA2102705OtherMAMSI
PA25-1716306OtherMULTIPLAN/PHCS
PA867633OtherMEDICARE GROUP #
PAP00058201OtherRAILROAD MEDICARE
PAPEARLOtherHEALTH AMERICA
PA1007307260034OtherMEDICAID GROUP #
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherINTERGROUP
PALI424256OtherHIGHMARK BLUESHIELD
PA120420410OtherDEPARTMENT OF LABOR
PABL8058857OtherDEA
PA7392409OtherAETNA NON-HMO
PABL8058857OtherDEA
PA25-1716306OtherINFORMED
PA867633OtherMEDICARE GROUP #
PAG920-0004/KDM4POOtherCAREFIRST
PA063817FLTMedicare PIN