Provider Demographics
NPI:1669440806
Name:LIBERMAN, HARRY ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:ANDRES
Last Name:LIBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5667 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1725
Mailing Address - Country:US
Mailing Address - Phone:404-252-5669
Mailing Address - Fax:404-252-9473
Practice Address - Street 1:780 CANTON RD NE
Practice Address - Street 2:SUITE 315
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7241
Practice Address - Country:US
Practice Address - Phone:770-794-7203
Practice Address - Fax:770-794-7204
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA048665208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00870141AMedicaid
GA00870141AMedicaid
GAH13889Medicare UPIN