Basic Information
Provider Information
NPI: 1851558993
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIANG
FirstName: QINGHUA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2695 ROCKY MOUNTAIN AVE
Address2: STE 150
City: LOVELAND
State: CO
PostalCode: 805388702
CountryCode: US
TelephoneNumber: 9706244443
FaxNumber: 9704904175
Practice Location
Address1: 1106 E PROSPECT RD
Address2: STE 100
City: FORT COLLINS
State: CO
PostalCode: 805255306
CountryCode: US
TelephoneNumber: 9704824373
FaxNumber: 9704845682
Other Information
ProviderEnumerationDate: 05/16/2008
LastUpdateDate: 04/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X51264COY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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