Individual
JOHN C LIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 S VAN DYKE, BAD AXE, MI 48413
(989) 269-9521
(989) 269-7948
Mailing address
PO BOX 102, BAD AXE, MI 48413-0102
(989) 269-9819
(989) 269-5212
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
039148
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1501860
—
MI
01
—
2213200311
BS
MI
Enumeration date
08/19/2006
Last updated
07/08/2007
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