Provider Demographics
NPI:1205217148
Name:DU, TIANLI (MD)
Entity type:Individual
Prefix:
First Name:TIANLI
Middle Name:
Last Name:DU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:7900 W JEFFERSON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4128
Practice Address - Country:US
Practice Address - Phone:260-458-3610
Practice Address - Fax:260-458-3611
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2024-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01091750A2086S0127X
MI4301107136208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery