Healthcare Provider Details

I. General information

NPI: 1114061736
Provider Name (Legal Business Name): LAURA LIEBERMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 140 VILLAGE ROAD SUITE 1
WESTMINSTER MD
21157-6196
US

IV. Provider business mailing address

332 140 VILLAGE ROAD SUITE 1
WESTMINSTER MD
21157-6196
US

V. Phone/Fax

Practice location:
  • Phone: 410-876-9680
  • Fax: 410-386-0876
Mailing address:
  • Phone: 410-876-9680
  • Fax: 410-386-0876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KEUN HEE OH
Title or Position: PRESIDENT
Credential: MD
Phone: 410-876-9680