Provider Demographics
NPI:1285684597
Name:LIBSTER, ALINA (MD)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:LIBSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11706 LOVEJOY ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1637
Mailing Address - Country:US
Mailing Address - Phone:973-767-3180
Mailing Address - Fax:
Practice Address - Street 1:11706 LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1637
Practice Address - Country:US
Practice Address - Phone:973-767-3180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036101039207V00000X
NJ25MA08320300207V00000X
MDD0069999207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL99714Medicare PIN
ILG38094Medicare UPIN
ILL99715Medicare PIN