Provider Demographics
NPI:1497856702
Name:LIERZ, MARK F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:F
Last Name:LIERZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HEARTLAND RD
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-6200
Mailing Address - Country:US
Mailing Address - Phone:816-232-8877
Mailing Address - Fax:816-232-0307
Practice Address - Street 1:901 HEARTLAND RD
Practice Address - Street 2:SUITE 1800
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-6200
Practice Address - Country:US
Practice Address - Phone:816-232-8877
Practice Address - Fax:816-232-0307
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101202174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC51740Medicare UPIN
MOE03687Medicare UPIN