Provider Demographics
NPI:1265793574
Name:LIEGNER, ADAM (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LIEGNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HORTON PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1747
Mailing Address - Country:US
Mailing Address - Phone:207-798-6200
Mailing Address - Fax:207-798-6290
Practice Address - Street 1:4 HORTON PL
Practice Address - Street 2:SUITE 101
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1747
Practice Address - Country:US
Practice Address - Phone:207-798-6200
Practice Address - Fax:207-798-6290
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine