Charles Marshall Lieder D.O.

NPI 1508163577 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1508163577
Gender Male
Enumeration Date 02/27/2011
Last Updated 02/27/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
20201 CRAWFORD AVE
OLYMPIA FIELDS IL, 60461-1010, US
Phone (708) 747-4000
Fax
Business Location
5954 EAGLES WAY
HASLETT MI, 48840-9762, US
Phone (517) 449-0059
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Charles Marshall Lieder D.O. NPI is 1508163577, taxonomy code is 390200000X Charles Marshall Lieder D.O. physically located at 20201 Crawford Ave, Olympia Fields IL, 60461-1010. NPI Number Charles Marshall Lieder D.O. has the Individual type.

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1508163577 NPI number is provided on an as is basis without warranty of any kind. 1508163577 is maintained by the National Plan & Provider Enumeration System. The contents of Charles Marshall Lieder D.O. are for informational purposes only.