Dr. Lisa G. Distefano
Internist Pediatrician
2016 S Main St
Maryville
, Missouri 64468-2655
Dr. Lisa G. Distefano
Internist Pediatrician
2016 S Main St
Maryville
, Missouri 64468-2655
(660) 562-4303
Write a Review Share Save Call
About
Features
Specialties
- Internist
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Lisa G. Distefano
- 114 E South Hills Dr
- Maryville, MO
- Zip : 64468-2659
- Fax : (660) 562-4303
- Phone : (660) 562-2525
Second Address
- Dr. Lisa G. Distefano
- 2016 S Main St
- Maryville, MO
- Zip : 64468-2655
- Fax : (660) 562-7993
- Phone : (660) 562-2525
Reviews
FAQs
Where did Dr. Lisa G. Distefano attend graduate school?
Where did Dr. Lisa G. Distefano do her residency?
Where did Dr. Lisa G. Distefano do her fellowship?
Is Dr. Lisa G. Distefano board certified?
What type of doctor is Dr. Lisa G. Distefano
In what state does Dr. Lisa G. Distefano practice in?
Where is Dr. Lisa G. Distefano ’s practice located?
What is Dr. Lisa G. Distefano ’s gender?
Is Dr. Lisa G. Distefano a sole practitioner?
Is Dr. Lisa G. Distefano accepting new patients?
What languages does Dr. Lisa G. Distefano speak?
Does Dr. Lisa G. Distefano accept insurance?
Does Dr. Lisa G. Distefano offers telemedicine?
What is Dr. Lisa G. Distefano ’s professional license number?
What is Dr. Lisa G. Distefano ’s NPI number?
Does Dr. Lisa G. Distefano have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 119536 | MO |
| Y | 111NI0900X | Internist | 119536 | MO |
| N | 208000000X | Pediatrician | 119536 | MO |
National Provider Identifier
| NPI | 1003810789 |
|---|---|
| Provider Name | Dr. Lisa G. Distefano |
| First Address | Maryville, MO 64468-2659 |
| Second Address | Maryville, MO 64468-2655 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2005 |
| Last Update Date | 09/11/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0520171 | (05) | IA |
| 204665202 | (05) | MO |
| G72305 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.