Organization
PUEBLO INFECTIOUS DISEASES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LIEBERMAN MD (PHYSICIAN)
(719) 369-7767
Entity
Organization
Contact information
Practice address
ST. MARY CORWIN MEDICAL CENTER, 1008 MINNEQUA AVE, PUEBLO, CO 81004
(719) 557-5000
Mailing address
1505 GUMWOOD DR, COLORADO SPRINGS, CO 80906-7707
(719) 369-7767
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
09/14/2009
Last updated
12/22/2009
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