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General NPI Number Information
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NPI Number | 1124209481
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Entity Type | Organization
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Legal Business Name | JEFREY D LIEBERMAN MD PC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 2680 LAWRENCEVILLE HWY STE 201
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City | DECATUR
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State | GA
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Zip | 30033-2526
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Country | US
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Telephone | 404-296-4911
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Fax | 404-296-1512
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Provider Business Mailing Address
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Address Line | 2680 LAWRENCEVILLE HWY STE 201
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City | DECATUR
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State | GA
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Zip | 30033-2526
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Country | US
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Telephone | 404-296-4911
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Fax | 404-296-1512
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Authorized Official
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Title or Position | OWNER
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Name | JEFREY D LIEBERMAN
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Credential | MD
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Telephone | 404-296-4911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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