Provider Demographics
NPI:1902975907
Name:LIU, ALLEN SHUYUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:SHUYUAN
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E VIRGINIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1254
Mailing Address - Country:US
Mailing Address - Phone:602-258-4788
Mailing Address - Fax:
Practice Address - Street 1:370 E VIRGINIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1254
Practice Address - Country:US
Practice Address - Phone:602-258-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ463132086S0122X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ154489OtherMEDICARE
AZ709015Medicaid
AZZ154489Medicare PIN