Provider Demographics
NPI:1700041522
Name:LIBEL, BERNARD E (B A, BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:E
Last Name:LIBEL
Suffix:
Gender:M
Credentials:B A, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 S BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2224
Mailing Address - Country:US
Mailing Address - Phone:816-676-2900
Mailing Address - Fax:816-676-2901
Practice Address - Street 1:1105 S BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2224
Practice Address - Country:US
Practice Address - Phone:816-676-2900
Practice Address - Fax:816-676-2901
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002030817174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist