Dietz, Lisa
Dietz, Lisa is an individual health care provider with primary practice located at 6507 Town Center Dr Suite A, Clarkston MI 48346-4826. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dietz, Lisa can be contacted via phone (248) 922-9975.Contact Information
Primary practice address
6507 Town Center Dr Suite A
Clarkston MI 48346-4826
Phone: (248) 922-9975
Fax: (248) 922-9143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | LD011820 | Michigan |
Profile Details
| NPI number | 1629067541 |
|---|---|
| LBN Legal business name | Dietz, Lisa |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Feb 19th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629067541 | NPPES |
| Michigan | MEDICAID | 4225528 |
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