Lisowsky, Taras
Lisowsky, Taras is an individual health care provider with primary practice located at 11300 E 13 Mile Rd Ste 1 , Warren MI 48093-2500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lisowsky, Taras can be contacted via phone (586) 777-6170.Contact Information
Primary practice address
11300 E 13 Mile Rd Ste 1
Warren MI 48093-2500
Phone: (586) 777-6170
Fax: (586) 777-6582
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101014940 | Michigan |
Profile Details
| NPI number | 1710961990 |
|---|---|
| LBN Legal business name | Lisowsky, Taras |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Nov 8th, 2022 - about 3 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 | 1710961990 | NPPES |
| Michigan | Other | 700H217350 | BLUE SHIELD |
| Michigan | MEDICAID | 1710961990 | BLUE SHIELD |
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