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NPI Code Detail

MEDICARE: ROBERT M LIESMAN DPM

MEDICARE:   ROBERT M LIESMAN  DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist356NC
2213E00000XPodiatrist356NC
3213EP1101XPrimary Podiatric Medicine Podiatrist356NC
4213ES0131XFoot Surgery Podiatrist356NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20268LOTHERNCBCBS

General Provider Information

NPI Number : 1548351687
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT M LIESMAN DPM
Provider Business Mailing Address
First Line : 2115 E 7TH ST
Second Line : SUITE 102
City : CHARLOTTE
State : NC
Zip : 28204-3307
Country : US
Telephone Number : 704-442-8433
Fax Number : 704-817-9957
Provider Business Practice Location Address
First Line : 2115 E 7TH ST
Second Line : SUITE 102
City : CHARLOTTE
State : NC
Zip : 28204-3307
Country : US
Telephone Number : 704-442-8433
Fax Number : 704-817-9957
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 04/29/2026

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