Individual
JOHN P LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1925 E ORMAN AVE, A245, PUEBLO, CO 81004-3537
(719) 560-5930
(719) 560-4930
Mailing address
1925 E ORMAN AVE, A245, PUEBLO, CO 81004-3537
(719) 560-5930
(719) 560-4930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15986241
—
CO
Enumeration date
06/29/2006
Last updated
10/20/2008
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