Healthcare Provider Details

I. General information

NPI: 1992782320
Provider Name (Legal Business Name): ARTHUR SAUL LIEBERMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 E FOURTEEN MILE RD MACOMB MEDICAL CLINIC PC
STERLING HEIGHTS MI
48310
US

IV. Provider business mailing address

2405 E FOURTEEN MILE RD MACOMB MEDICAL CLINIC PC
STERLING HEIGHTS MI
48310
US

V. Phone/Fax

Practice location:
  • Phone: 586-264-1800
  • Fax: 586-264-1155
Mailing address:
  • Phone: 586-264-1800
  • Fax: 586-264-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101005470
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: