Provider Demographics
NPI:1023093895
Name:LIU, LE WEN (MD PHD)
Entity type:Individual
Prefix:DR
First Name:LE WEN
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:LE-WEN
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 47340
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7340
Mailing Address - Country:US
Mailing Address - Phone:316-685-6112
Mailing Address - Fax:316-652-0340
Practice Address - Street 1:550 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4910
Practice Address - Country:US
Practice Address - Phone:316-685-6112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036101837207ZP0102X
KS04-29744207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100198670AMedicaid
KS102174OtherBCBS OF KS
KS100423140AMedicaid
KS220032553OtherRAILROAD MEDICARE
KS100423140AMedicaid