Individual
DR. CARL NELSON LIEDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
841 E HUNTING PARK AVE, SUITE 110, PHILADELPHIA, PA 19124-4800
(215) 535-4494
(215) 535-4203
Mailing address
841 E HUNTING PARK AVE, SUITE 110, PHILADELPHIA, PA 19124-4800
(215) 535-4494
(215) 535-4203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
193400000X
PA
207Q00000X
Family Medicine Physician
Primary
OS004520L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00422
HEALTH PARTNERS
PA
01
—
0075139402
AMERICHOICE
PA
01
—
100008
KEYSTONE MERCY
PA
01
—
108074
AETNA
PA
01
—
110159242
TRAVELORS
PA
01
—
173358
BLUE SHIELD
PA
01
—
6128979
CIGNA
PA
01
—
PA10333
ELDER HEALTH
PA
Enumeration date
06/17/2005
Last updated
09/19/2016
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