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Individual
MS. ANDREA I LIATIS
Active
Individual
MS. ANDREA I LIATIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7492
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003156873D
—
GA
05
—
003156873E
—
GA
05
—
003156873F
—
GA
01
—
202I975284
MEDICARE PTAN
GA
Enumeration date
02/09/2015
Last updated
08/17/2020
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