Individual
DR. JASON M LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF EMERGENCY MEDICINE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
48096
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039906263U
HUMANA
—
05
—
1528010105
—
WI
05
—
34646400
—
WI
Enumeration date
05/16/2006
Last updated
11/08/2012
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