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Contact Information

DOUGLAS LIEPERT, MD
53760 GENERATIONS DR
SOUTH BEND, IN46635-1539
 Phone: 574-500-2010
 Fax: 888-919-1083
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sleep Medicine

207YS0012X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for DOUGLAS LIEPERT · (Male)

NPI Number 1083675011
Status Active
Credentials MD
Entity Individual
Enumeration date 03/29/2006
Last updated 04/05/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 01068512A
  • IN License # 01068512B
  • IN Medicaid 200987130
  • MN Medicaid 899690300
  • WI Medicaid 1083675011
Hospital affiliation(s)
  • IU HEALTH GOSHEN HOSPITAL - (Acute Care)
    200 HIGH PARK AVE
    GOSHEN, IN 46526
  • SAINT JOSEPH REGIONAL MEDICAL CENTER - (Acute Care)
    5215 HOLY CROSS PKWY
    MISHAWAKA, IN 46545
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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