Dietz, Lisa

Dietz, Lisa is an individual health care provider with primary practice located at 6507 Town Center Dr Suite A, Clarkston MI 48346-4826. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dietz, Lisa can be contacted via phone (248) 922-9975.

Contact Information

Primary practice address
6507 Town Center Dr Suite A Clarkston MI 48346-4826
Phone: (248) 922-9975
Fax: (248) 922-9143
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X LD011820 Michigan

Profile Details

NPI number 1629067541
LBN Legal business name Dietz, Lisa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Feb 19th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629067541 NPPES
Michigan MEDICAID 4225528

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