Individual
MICHAEL S LIEBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 MICHIGAN AVE., #390, LOGANSPORT, IN 46947
(574) 722-1313
(574) 735-3058
Mailing address
132 W COUNTY ROAD 200 N, LOGANSPORT, IN 46947-8753
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01028086
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF3161
RAILROAD MEDICARE
IN
Enumeration date
06/28/2006
Last updated
10/23/2007
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