Provider Demographics
NPI:1457467268
Name:LIU, WU YEN (MD)
Entity Type:Individual
Prefix:
First Name:WU
Middle Name:YEN
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WAYNE
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3611 BRANCH AVENUE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1242
Mailing Address - Country:US
Mailing Address - Phone:301-423-5540
Mailing Address - Fax:301-423-8491
Practice Address - Street 1:3611 BRANCH AVENUE
Practice Address - Street 2:SUITE 305
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1242
Practice Address - Country:US
Practice Address - Phone:301-423-5540
Practice Address - Fax:301-423-8491
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026605207Y00000X
DCMD12997207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
06810OtherAMERIGROUP
1000301OtherUNITED HEALTHCARE
27043OtherEMP HEALTH JOHN HOPKINS P
9806936OtherCIGNA
G01431W01OtherMEDICARE PROV ID
0738097OtherAETNA US HEALTHCARE
269798OtherANTHEM BCBS
MD33082001OtherBCBS MD RENDERING
DCJ0810001OtherBCBS OF DC
VA013219OtherBCBS
MD0L59WOtherBCBS
313708OtherMAMSI ALLIANCE OPT CH MDI
4053210OtherAETNA SELECT CHOICE
494036OtherNCPPO
MD33082001OtherBCBS MD RENDERING
27043OtherEMP HEALTH JOHN HOPKINS P