Theodore W Liao (NPI# 1184937013, PAC ID# 3577791979) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1184937013 |
| PAC ID by PECOS | 3577791979 |
| Professional Enrollment ID | I20140109001757 |
| Full Name | Theodore W Liao |
| Organization Legal Name | CHERRY STREET SERVICES INC |
| Address |
550 Se Cherry St Grand Rapids MI 49503-4748 |
| Phone Number | 6162357272 |
| Gender | M |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2010 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6800707647 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230038 | SPECTRUM HEALTH-BUTTERWORTH CAMPUS |
| Address | Phone | Organization |
|---|---|---|
| 550 Se Cherry St, Grand Rapids, MI 49503-4748 | 6162357272 | CHERRY STREET SERVICES INC |
| Organization Legal Name | CHERRY STREET SERVICES INC |
| Physicians | 51 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leslie R Pelkey | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Marc A Bush | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Diba Rahmani | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Daniel S Stout | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Paul H Bryant | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Thomas C Platt | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Kacie Grey | Clinical Social Worker | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Karli R Reich | Nurse Practitioner | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Lori Nieboer | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Abha G Varma | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Street Address |
550 SE CHERRY ST |
| City | GRAND RAPIDS |
| State | MI |
| Zip | 49503-4748 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leslie R Pelkey | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Marc A Bush | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Diba Rahmani | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Daniel S Stout | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Paul H Bryant | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Thomas C Platt | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Kacie Grey | Clinical Social Worker | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Karli R Reich | Nurse Practitioner | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Lori Nieboer | Physician Assistant | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Abha G Varma | Internal Medicine | Cherry Street Services Inc | 550 Se Cherry St, Grand Rapids, MI 49503-4748 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yaw Appiagyei-dankah | Pediatric Medicine | Spectrum Health Primary Care Partners | 230 Michigan Ave Ne, Grand Rapids, MI 49503 |
| Steven G Hamming | Psychologist, Clinical | 85 Campau Nw, Suite 100, Grand Rapids, MI 49503 | |
| Scott Douglas Hadley | Physical Therapy | 1140 Monroe Ave Nw, Suite 5201, Grand Rapids, MI 49503-1070 | |
| Doreen T Berrios | Nurse Practitioner | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Jaclyn Michelle Abbate | Clinical Social Worker | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Karen Georgianna O'strander | Clinical Social Worker | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Richard E Myers | Psychiatry | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Patrick J Handlin | Physician Assistant | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Courtney E Kozarian | Clinical Social Worker | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Jillaine A Ruppel | Nurse Practitioner | Hope Network Behavorial Health Services | 385 Leonard Ne, Pivot Case Mgmt, Grand Rapids, MI 49503-1129 |
| Find all physicians in zip 49503 | |||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | GRAND RAPIDS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Theodore W Liao.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.