Provider Demographics
NPI:1477556587
Name:LIEBMANN, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:LIEBMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:85 HERRICK STREET
Mailing Address - Street 2:NORTHEAST ONCOLOGY BEVERLY HOSPITAL
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:HEMATOLOGY/ONCOLOGY
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:508-334-7098
Practice Address - Fax:508-856-6715
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2017-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA238144207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM21384Medicaid
NM21384Medicaid
569024637MMedicare ID - Type Unspecified