Individual
DR. MICHAEL D LIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
212 CREEK CROSSING BLVD, HAINESPORT, NJ 08036-2766
(609) 267-1004
(609) 267-1044
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(609) 267-1004
(609) 267-1044
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25MB09114300
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0422185
—
NJ
Enumeration date
09/05/2008
Last updated
10/17/2024
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