Provider Demographics
NPI:1730409459
Name:LIU, EVAN YOUNG (MD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:YOUNG
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 1:2360 N FEATHERING LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1967
Mailing Address - Country:US
Mailing Address - Phone:610-357-0510
Mailing Address - Fax:
Practice Address - Street 1:2360 N FEATHERING LN
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1967
Practice Address - Country:US
Practice Address - Phone:610-357-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039813E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine