Healthcare Provider Details

I. General information

NPI: 1588148886
Provider Name (Legal Business Name): JULIA MARGARET LIEBERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FERRY RD
ATLANTA GA
30342-1605
US

IV. Provider business mailing address

PO BOX 422002
ATLANTA GA
30342-9002
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number104149
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number104149
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: