Individual
DR. LISA A DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
36100 EUCLID AVE, #490, WILLOUGHBY, OH 44094-4456
(440) 953-1818
(440) 953-8653
Mailing address
10605 MULBERRY RD, CHARDON, OH 44024-8702
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
35-06-5167-D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000127718
ANTHEM
OH
01
—
1300195
UNITED HEALTH CARE
OH
05
—
2027943
—
OH
01
—
5143509
AETNA
OH
01
—
80616
QUAL CHOICE
OH
Enumeration date
09/27/2006
Last updated
07/08/2007
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