Individual
JONATHAN KIRK LIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
24 N WALNUT ST STE 100, HAGERSTOWN, MD 21740-4741
(240) 452-3400
Mailing address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2237
WV
363A00000X
Physician Assistant
Primary
C07533
MD
Other
Enumeration date
03/15/2019
Last updated
04/27/2020
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