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Individual

LIBERATA J PANTIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1117 S VAN DYKE RD, SUITE 400, BAD AXE, MI 48413-8467
(989) 269-6048
(989) 269-6174
Mailing address
1117 S VAN DYKE RD, SUITE 400, BAD AXE, MI 48413-8467
(989) 269-6048
(989) 269-6174

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301031546
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4675512
MI
Enumeration date
03/08/2006
Last updated
09/01/2010
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