Healthcare Provider Details

I. General information

NPI: 1841067006
Provider Name (Legal Business Name): EXPERT INFECTIOUS DISEASES CONSULTING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 12/07/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3329 E BAYAUD AVE
DENVER CO
80209
US

IV. Provider business mailing address

6510-A S ACADEMY BLVD # 103
COLORADO SPRINGS CO
80906-8691
US

V. Phone/Fax

Practice location:
  • Phone: 719-470-2766
  • Fax:
Mailing address:
  • Phone: 719-470-2766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN LIEBERMAN
Title or Position: OWNER
Credential: MD
Phone: 719-470-2766