Individual
KATHERINE GO LIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1601 ROOSEVELT RD, NIAGARA, WI 54151-1043
(715) 251-1780
(715) 251-1787
Mailing address
1601 ROOSEVELT RD, PO BOX 6, NIAGARA, WI 54151-1043
(888) 724-6377
(715) 251-1681
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
42715-020
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301077176
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
42715-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050077646
RAILROAD MEDICARE
MI
01
—
050077649
RAILROAD MEDICARE
WI
01
—
050B210120
BCBS
MI
01
—
1027531
PREFERRED ONE
—
05
—
34051000
—
WI
05
—
4259562
—
MI
05
—
4782512
—
MI
05
—
4782568
—
MI
05
—
4782601
—
MI
Enumeration date
02/03/2006
Last updated
03/18/2013
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