Individual
MARK D LIVEZEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
5555 PEACHTREE DUNWOODY RD NE, ATLANTA, GA 30342-1703
(404) 255-9286
(404) 250-0740
Mailing address
5555 PEACHTREE DUNWOODY RD NE, ATLANTA, GA 30342-1703
(404) 255-9286
(404) 250-0740
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
031064
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238540
BLUE CROSS/BLUE SHIELD
—
Enumeration date
01/30/2006
Last updated
07/08/2007
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