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Individual

JOHN A LIEBERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4401 N CAMPUS RIDGE DR, SUITE B2200, MIDLAND, MI 48640-6112
(989) 837-9400
Mailing address
4401 N CAMPUS RIDGE DR, SUITE B2200, MIDLAND, MI 48640-6112
(989) 837-9400

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5315016828
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912995762
MI
05
4615318
MI
Enumeration date
10/06/2005
Last updated
09/07/2012
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