Individual
DR. SERENA MCCLAM LIEBENGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MHS
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-9446
Mailing address
PO BOX 64358, BALTIMORE, MD 21264-4358
(410) 356-8186
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
9557275
DC
2085R0202X
Diagnostic Radiology Physician
Primary
D70319
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035196200
—
MD
Enumeration date
01/20/2010
Last updated
05/08/2012
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