Individual
NATHAN A. LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1635A OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 483-2020
(910) 483-0311
Mailing address
1635A OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 483-2020
(910) 483-0311
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1499
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0906G
BCBS
NC
05
—
890904U
—
NC
Enumeration date
06/12/2006
Last updated
02/15/2012
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