Organization
MOUNTAIN LAUREL INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIEBMAN MD (OWNER)
(864) 722-5915
Entity
Organization
Contact information
Practice address
1510 BLUE RIDGE BLVD STE 105, SENECA, SC 29672-6684
(864) 722-5315
Mailing address
1510 BLUE RIDGE BLVD STE 105, SENECA, SC 29672-6684
(864) 722-5315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T30712
—
SC
Enumeration date
07/03/2018
Last updated
07/03/2018
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