Provider Demographics
NPI:1932211232
Name:LIU, MING-JAI (MD, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MING-JAI
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72075
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1018
Mailing Address - Country:US
Mailing Address - Phone:505-228-2306
Mailing Address - Fax:505-485-0404
Practice Address - Street 1:426 E SOUTHERN AVE STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5215
Practice Address - Country:US
Practice Address - Phone:602-649-1555
Practice Address - Fax:602-649-1554
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP6422183500000X
AZ477012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ858713Medicaid