Provider Demographics
NPI:1366499758
Name:MIN, LILIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LILIANE
Middle Name:
Last Name:MIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:825 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3231
Mailing Address - Country:US
Mailing Address - Phone:610-527-3800
Mailing Address - Fax:610-527-0334
Practice Address - Street 1:825 OLD LANCASTER RD
Practice Address - Street 2:SUITE 320
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3231
Practice Address - Country:US
Practice Address - Phone:610-527-3800
Practice Address - Fax:610-527-0334
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2017-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD420576207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017963200002Medicaid
PA1017963200002Medicaid