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Individual

BENJAMIN D LIESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 FODEN RD, WEST, SUITE 100, SOUTH PORTLAND, ME 04106-2327
(207) 347-2910
(207) 523-8591
Mailing address
144 US ROUTE 1 STE 1, SCARBOROUGH, ME 04074-7219
(207) 415-4841
(888) 612-5691

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
2009014370
MO
207Y00000X
Otolaryngology Physician
Primary
MD18388
ME
207Y00000X
Otolaryngology Physician
T2004016418
MO

Other

Enumeration date
09/11/2006
Last updated
12/03/2025
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