Individual
DR. MARK LIBERTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6229 N APPLECROSS RD, HIGHLAND HEIGHTS, OH 44143-3726
(440) 646-1651
(440) 646-1651
Mailing address
6229 N APPLECROSS RD, HIGHLAND HEIGHTS, OH 44143-3726
(440) 646-1651
(440) 646-1651
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35055788L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000140712
ANTHEM
OH
01
—
1879024002
CIGNA
OH
05
—
2060479
—
OH
01
—
341865880001
MEDICAL MUTUAL
OH
01
—
341865880028
CARESOURCE
OH
01
—
50875
QUALCHOICE
OH
Enumeration date
12/06/2005
Last updated
10/08/2012
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