Individual
BROCK ARMSTRONG LIDEN
Active
Individual
BROCK ARMSTRONG LIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
36-00-3103-L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095281
—
OH
01
—
7887840001
NATIONAL SUPPLIER CLEARINGHOUSE
OH
01
—
P00287259
RR MEDICARE R PIN
—
Enumeration date
07/05/2005
Last updated
06/08/2021
Update your record
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