Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 1858 | ME |
N | 207Q00000X | Family Doctor | 249400 | MA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 249400 | MA |
NPI | 1346353687 |
---|---|
Provider Name | Dr. Karl F Liebermann |
First Address | Westwood, MA 02090-2206 |
Second Address | Westwood, MA 02090-2206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4218213 | AETNA HMO (01) | |
432373499 | (05) | ME |
5996726002 | CIGNA (01) | |
AA3544 | HARVARD PILGRIM (01) | |
I36305 | (02) | ME |