Organization
MODERN RICHMOND ENDOCRINOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANZA LIU MD (PRESIDENT)
(804) 267-6920
Entity
Organization
Contact information
Practice address
1467 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 267-6920
(804) 267-6921
Mailing address
1467 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 267-6920
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101247055
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101247055
STATE BOARD LICENSE
VA
Enumeration date
04/11/2016
Last updated
06/01/2020
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