# LISA LEE GUSHWA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598798316
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 11969 | MT | Yes |
| 207Q00000X | Family Medicine Physician | 34251 | AZ | — |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 04/15/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 978992 | — | AZ |
| 01 | — | P00457901 | RAILROAD MEDICARE | AZ |