Provider Demographics
NPI:1255334686
Name:LIU, LINDA (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6001 MONTROSE RD
Mailing Address - Street 2:STE 211
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4872
Mailing Address - Country:US
Mailing Address - Phone:301-468-1451
Mailing Address - Fax:301-468-3580
Practice Address - Street 1:6430 ROCKLEDGE DR STE 300
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1847
Practice Address - Country:US
Practice Address - Phone:301-468-1451
Practice Address - Fax:301-468-3580
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034925207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD209021000Medicaid
MDC88178Medicare UPIN
MD171791Medicare ID - Type Unspecified