Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E10000173 | DE |
Y | 222Z00000X | Podiatrist | E10000173 | DE |
NPI | 1003816646 |
---|---|
Provider Name | Dr. Lisa Michaels |
First Address | West Chester, PA 19380-7039 |
Second Address | West Chester, PA 19380-7039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 06/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000600450 | (05) | DE |
1000034829 | (05) | DE |
V00935 | (02) | DE |