Provider Demographics
NPI:1265551196
Name:LIBERMAN, JOSHUA DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:LIBERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11725 N PORT WASHINGTON RD STE 250
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3486
Mailing Address - Country:US
Mailing Address - Phone:414-207-4333
Mailing Address - Fax:888-720-0492
Practice Address - Street 1:11725 N PORT WASHINGTON RD STE 250
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3486
Practice Address - Country:US
Practice Address - Phone:414-207-4333
Practice Address - Fax:888-720-0492
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2024-07-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI51496207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI42310Medicare UPIN