Provider Demographics
NPI:1386618189
Name:LIBURD, CHIMENE LINETTE (MD)
Entity type:Individual
Prefix:
First Name:CHIMENE
Middle Name:LINETTE
Last Name:LIBURD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3489
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114
Mailing Address - Country:US
Mailing Address - Phone:410-451-9888
Mailing Address - Fax:410-451-9876
Practice Address - Street 1:2401 BRANDERMILL BLVD
Practice Address - Street 2:S-330
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054
Practice Address - Country:US
Practice Address - Phone:410-451-9888
Practice Address - Fax:410-451-9876
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0054020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H10441Medicare UPIN
MD170P402GMedicare ID - Type Unspecified