Individual
DR. HAROLD J LIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
217 BRECKENRIDGE LN, LOUISVILLE, KY 40207-3858
(502) 895-9421
(502) 899-5762
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25408
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000777754
ANTHEM - KCMA
KY
01
—
137158
SIHO - KCMA
KY
01
—
50039819
PASSPORT - KCMA
KY
05
—
64254089
—
KY
Enumeration date
06/27/2005
Last updated
03/28/2018
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