Mark Libertin, MD, Inc.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

35055788L Issued in OH

Legal business name

MARK LIBERTIN, MD, INC.

Practice address

29001 Cedar Rd Ste 201
Lyndhurst, OH 44124-4041

Phone

(440) 605-5900

NPI assigned

Jan 2, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Libertin, M.D.

Title

President

Phone

(440) 605-5900

Specialties & licenses 1

Addresses

Other names 1

• Libertin and Rao, Inc. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1932384518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD STE 201",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244041",
            "telephone_number": "440-605-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD STE 201",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244041",
            "telephone_number": "440-605-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK LIBERTIN, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "LIBERTIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-605-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OH",
            "license": "35055788L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Libertin and Rao, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Obstetrics Physician in Lyndhurst, OH
• Providers in Lyndhurst, OH by specialty
• Obstetrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.