Liston, Audrey
Liston, Audrey is an individual health care provider with primary practice located at 787 Market St Ste 9 , Hancock MI 49930. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Liston, Audrey can be contacted via phone (906) 482-7762.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101012074 | Michigan |
Profile Details
| NPI number | 1346354461 |
|---|---|
| LBN Legal business name | Liston, Audrey |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2006 |
| Last updated | Jan 16th, 2019 - about 7 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 | 1346354461 | NPPES |
| Michigan | Other | 0C16002 | MEDICARE GROUP |
| Michigan | Other | AL012074 | MEDICARE GROUP |
| Michigan | MEDICAID | 114387160 | MEDICARE GROUP |
| Michigan | Other | 0829560001 | MEDICARE GROUP |
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