Thomas, Lisa R
Thomas, Lisa R is an individual health care provider with primary practice located at 119 Gannett Dr , South Portland ME 04106-6942. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Thomas, Lisa R can be contacted via phone (207) 774-2642.Contact Information
Primary practice address
119 Gannett Dr
South Portland ME 04106-6942
Phone: (207) 774-2642
Fax: (207) 774-4293
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD15368 | Maine |
Profile Details
| NPI number | 1508892449 |
|---|---|
| LBN Legal business name | Thomas, Lisa R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Jun 26th, 2012 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508892449 | NPPES |
| Maine | MEDICAID | 269070099 | |
| Maine | MEDICAID | 30201604 | |
| Maine | Other | 038667 |
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