Individual
DOUGLAS LIEPERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 500-2010
(888) 919-1083
Mailing address
10001 W INNOVATION DR STE 200, MILWAUKEE, WI 53226-4851
(888) 938-3838
(888) 919-1083
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01068512B
IN
207YS0012X
Sleep Medicine (Otolaryngology) Physician
Primary
01068512A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083675011
—
WI
05
—
200987130
—
IN
05
—
899690300
—
MN
Enumeration date
03/29/2006
Last updated
04/05/2022
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