Lyster, Michael T

Lyster, Michael T is an individual health care provider with primary practice located at 101 Civic Center Ln , Lake Havasu City AZ 86403-5607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Lyster, Michael T can be contacted via phone (928) 453-3761.

Contact Information

Primary practice address
101 Civic Center Ln Lake Havasu City AZ 86403-5607
Phone: (928) 453-3761
Fax: (928) 453-3771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036081248 Illinois

Profile Details

NPI number 1114916350
LBN Legal business name Lyster, Michael T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Jun 15th, 2010 - about 16 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 1114916350 NPPES
Illinois MEDICAID 036081248
Illinois MEDICAID 505784

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