MEDICARE: SPENCER S LIEM MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program		FL
2	208800000X	Urology Physician	31119	FL
3	208800000X	Urology Physician	489130	PA

General Provider Information

NPI Number	:	1619596095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER S LIEM MD

Provider Business Mailing Address
First Line	:	400 OXFORD DR STE 100
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-6310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 OXFORD DR STE 100
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-6310
Country	:	US
Telephone Number	:	412-380-5063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2020
Last Update Date	:	04/06/2026

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Directions to “ SPENCER S LIEM MD” Practice Location

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