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Individual

DR. SHAN LIU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
55 FRUIT ST, ZERO EMERSON, ROOM 358, BOSTON, MA 02114-2621
(617) 726-4809
Mailing address
55 FRUIT ST, ZERO EMERSON, ROOM 358, BOSTON, MA 02114-2621
(617) 726-4809

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
220158
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2068681
MA
01
469403
TUFTS HEALTH PLAN
MA
01
J27648
BCBS MA
MA
Enumeration date
11/10/2005
Last updated
07/08/2007
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