Lisowsky, Taras

Lisowsky, Taras is an individual health care provider with primary practice located at 11300 E 13 Mile Rd Ste 1 , Warren MI 48093-2500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lisowsky, Taras can be contacted via phone (586) 777-6170.

Contact Information

Primary practice address
11300 E 13 Mile Rd Ste 1 Warren MI 48093-2500
Phone: (586) 777-6170
Fax: (586) 777-6582
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101014940 Michigan

Profile Details

NPI number 1710961990
LBN Legal business name Lisowsky, Taras
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Nov 8th, 2022 - 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 1710961990 NPPES
Michigan Other 700H217350 BLUE SHIELD
Michigan MEDICAID 1710961990 BLUE SHIELD

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