Provider Demographics
NPI:1386646453
Name:LIEBOWITZ, STEVEN MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARC
Last Name:LIEBOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3850 ED DRIVE
Mailing Address - Street 2:STE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8037
Mailing Address - Country:US
Mailing Address - Phone:919-788-9588
Mailing Address - Fax:919-645-1640
Practice Address - Street 1:3850 ED DRIVE
Practice Address - Street 2:STE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8037
Practice Address - Country:US
Practice Address - Phone:919-788-9588
Practice Address - Fax:919-645-1640
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC32763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951908Medicaid
208236DMedicare PIN
NC8951908Medicaid
NC208236AMedicare PIN