Individual
DR. LIBERTY BELLE SHELTON HOBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 136TH AVE, SUITE 416, HOLLAND, MI 49424-2923
(616) 738-0470
(616) 738-0498
Mailing address
400 136TH AVE, SUITE 416, HOLLAND, MI 49424-2923
(616) 738-0470
(616) 738-0498
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301068128
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020G010060
BLUE CROSS BLUE SHIELD MI
MI
01
—
382809956
COMMERCIAL
—
05
—
4783476
—
MI
Enumeration date
04/14/2006
Last updated
01/06/2014
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