Organization Name: | DR. GARY A. LIEBERMAN, P.A. |
NPI Number: | 1023017654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY A LIEBERMAN (PODIATRIST) |
Mailing Address: | 10101 Lorain Ave Silver Spring |
State: | MD US |
Postal Code: | 209012458 |
Phone Number: | 3016818400 |
Fax Number: | 3016813339 |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 00532 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |