Individual
YIYAN LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5875
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
25MA07759500
NJ
207U00000X
Nuclear Medicine Physician
Primary
TP643
KY
207UN0901X
Nuclear Cardiology Physician
25MA07759500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059382
—
NJ
01
—
MEDICARE
K355840
KY
Enumeration date
07/12/2006
Last updated
12/07/2020
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