Provider Demographics
NPI:1659340818
Name:LIEB, JAMES V (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:V
Last Name:LIEB
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Mailing Address - Street 1:1800 EAST PARK AVE
Mailing Address - Street 2:LANCE AND ELLEN SHANER CANCER PAVILION
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6797
Mailing Address - Country:US
Mailing Address - Phone:814-231-7800
Mailing Address - Fax:814-231-7295
Practice Address - Street 1:1800 EAST PARK AVE
Practice Address - Street 2:LANCE AND ELLEN SHANER CANCER PAVILION
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6797
Practice Address - Country:US
Practice Address - Phone:814-231-7800
Practice Address - Fax:814-231-7295
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010559L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH18947Medicare UPIN
PA239357D9RMedicare PIN
PA1010722590001Medicaid