Provider Demographics
NPI:1861401846
Name:LIEBERMAN, MURRAY (MD)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CROSSROADS DRIVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:443-738-2872
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:#503
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:301-530-1700
Practice Address - Fax:301-530-0418
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD17365208800000X
MDDO032270208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211831900Medicaid
MD211831900Medicaid
C88579Medicare UPIN
MDKD82UROtherCAREFIRST BCBS
27244OtherJOHNS HOPKINS HEALTHCARE
0521124OtherAETNA US HEALTHCARE
0935263OtherCIGNA
1900053OtherUNITED HEALTHCARE EVERCAR
400794U22Medicare ID - Type Unspecified
1900160OtherUNITED HEALTHCARE
4066882OtherAETNA US HEALTHCARE
036886OtherVA BS ANTHEM BETHESDA
C88579Medicare UPIN
182863OtherVA BS ANTHEM GERMANTOWN
25130OtherCOVENTRY HEALTHCARE OF DE
55187OtherFIRST HEALTHCCN