Daitch, Lisa H.

Daitch, Lisa H. is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Daitch, Lisa H. can be contacted via phone (706) 721-2505.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-2505
Fax: (706) 721-1500
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 003202 Georgia

Profile Details

NPI number 1861502445
LBN Legal business name Daitch, Lisa H.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Mar 31st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861502445 NPPES
South Carolina MEDICAID QM0720
South Carolina MEDICAID 100001419A

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