Provider Demographics
NPI:1427019850
Name:LIEBIG, TINA TRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:TRAN
Last Name:LIEBIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7640 ARGYLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-1702
Mailing Address - Country:US
Mailing Address - Phone:904-891-5308
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-9011
Practice Address - Fax:904-953-8878
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA559932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology