Gold, Lisa Camille

Gold, Lisa Camille is an individual health care provider with primary practice located at 1141 S Indiana Ave , Crown Point IN 46307-7205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gold, Lisa Camille can be contacted via phone (219) 662-0700.

Contact Information

Primary practice address
1141 S Indiana Ave Crown Point IN 46307-7205
Phone: (219) 662-0700
Fax: (219) 662-0973
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01044839 Indiana

Profile Details

NPI number 1023015302
LBN Legal business name Gold, Lisa Camille
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jul 31st, 2023 - about 2 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 1023015302 NPPES
Indiana MEDICAID 200084250

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