Dr. Matthew Eric Lissauer
Trauma Surgeon Surgical Critical Care
22 S Greene St
Baltimore
, Maryland 21201-1544
Dr. Matthew Eric Lissauer
Trauma Surgeon Surgical Critical Care
22 S Greene St
Baltimore
, Maryland 21201-1544
(410) 382-4124
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About
Features
Specialties
- Surgical Critical Care
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Matthew Eric Lissauer
- Po Box 64793
- Baltimore, MD
- Zip : 21264-4793
- Fax : (410) 382-4124
- Phone : (410) 328-6704
Second Address
- Dr. Matthew Eric Lissauer
- 22 S Greene St
- Baltimore, MD
- Zip : 21201-1544
- Fax : (410) 328-4124
- Phone : (410) 328-6704
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 2086S0102X | Surgical Critical Care | 69621 | CT |
| N | 2086S0102X | Surgical Critical Care | D63229 | MD |
| Y | 2086S0127X | Trauma Surgeon | 69621 | CT |
| N | 2086S0127X | Trauma Surgeon | D0063229 | MD |
National Provider Identifier
| NPI | 1306808019 |
|---|---|
| Provider Name | Dr. Matthew Eric Lissauer |
| First Address | Baltimore, MD 21264-4793 |
| Second Address | Baltimore, MD 21201-1544 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/04/2006 |
| Last Update Date | 13/10/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 408282600 | (05) | MD |
| I39430 | (02) | MD |
| P00259987 | RAILROAD MEDICARE (01) | MD |
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.