Liscow, David Michael

Liscow, David Michael is an individual health care provider with primary practice located at 930 Blue Star Hwy , South Haven MI 49090-7758. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Liscow, David Michael can be contacted via phone (269) 637-1115.

Contact Information

Primary practice address
930 Blue Star Hwy South Haven MI 49090-7758
Phone: (269) 637-1115
Fax: (269) 639-1314
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301048560 Michigan

Profile Details

NPI number 1689786154
LBN Legal business name Liscow, David Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Dec 1st, 2020 - about 4 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 1689786154 NPPES
Michigan Other 080H06004 BCBSM
Michigan Other 080027374 BCBSM
Michigan MEDICAID 1656193 BCBSM
Michigan Other 0131169 BCBSM
Michigan Other P53524 BCBSM
Michigan Other 5468088 BCBSM

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