Organization
MARIA LIVIERATOS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LIVIERATOS M.D., (SINGLE MEMBER)
(248) 620-1275
Entity
Organization
Contact information
Practice address
5799 S MAIN ST, #1472, CLARKSTON, MI 48347-9907
(248) 620-1275
Mailing address
5799 S. MAIN ST. #1472, CLARKSTON, MI 48347-1472
(248) 620-1275
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301064240
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301064240
BOARD OF MEDICINE PHYSICI
MI
Enumeration date
06/07/2007
Last updated
05/04/2015
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