Basic Information
| Provider Information | |||||||||
| NPI: | 1104815059 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIANG | ||||||||
| FirstName: | WEN | ||||||||
| MiddleName: | CHI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12622 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816573 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 MEDICAL PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214013742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434815300 | ||||||||
| FaxNumber: | 4434816705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 12/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 34006614 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | H65424 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 58860016 | 01 | BCBS DC | OTHER | 955613-03 | 01 | BCBS MARYLAND | OTHER | 95561304 | 01 | MD | BCBS | OTHER | V8080006 | 01 | DC | BCBS | OTHER | 6067644 | 01 | AETNA HMO | OTHER | 2713184 | 01 | OH | GROUP MCD # | OTHER | 7719360 | 01 | AETNA PPO | OTHER | 95561301 | 01 | BCBS MD | OTHER | V8380006 | 01 | DC | BCBS | OTHER | V8740005 | 01 | DC | BCBS | OTHER | 9365601 | 01 | OH | GROUP MCR # | OTHER | 95561302 | 01 | MD | BCBS | OTHER | 2043541 | 05 | OH | MEDICAID | 417471200 | 05 | MD | MEDICAID |