Jessica Bistafa Liu, MD
Internal Medicine, Geriatric Medicine in Atlanta, GA. Individual provider (NPI-1).
NPI number1164085015
StatusActive
Last updated in NPPESMay 28, 2024
Details
- NPI
- 1164085015
- Entity type
- Individual (NPI-1)
- Name
- Jessica Bistafa Liu
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 16, 2019
- Certification date
- May 28, 2024
- Last updated
- May 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RG0300X | Internal Medicine, Geriatric Medicine | 100031 | GA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | MA |
Practice location
5673 Peachtree Dunwoody Rd Ste 500Atlanta, GA 30342-2147
Phone 404-778-7402
Mailing address
Po Box 102632Atlanta, GA 30368-2632
Phone 404-778-7402
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