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General NPI Number Information
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NPI Number | 1841488954
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Entity Type | Organization
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Legal Business Name | ELIZABETH A. LIOTTA, M.D.,L.L.C
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 77 THOMAS JOHNSON DR SUITE C
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City | FREDERICK
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State | MD
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Zip | 21702-4893
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Country | US
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Telephone | 301-668-3004
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Fax | 301-668-3005
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Provider Business Mailing Address
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Address Line | 77 THOMAS JOHNSON DR SUITE C
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City | FREDERICK
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State | MD
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Zip | 21702-4893
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Country | US
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Telephone | 301-668-3004
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Fax | 301-668-3005
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | DR. ELIZABETH ANN LIOTTA
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Credential | M.D.
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Telephone | 301-668-3004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0046908
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License Number State | MD
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