Individual
MICHAEL BRIAN LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 SABIN STREET, 725 WALTON BLDG, CHARLESTON, SC 29425
(843) 792-0592
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
AL34690
SC
207RX0202X
Medical Oncology Physician
Primary
34690
SC
207RX0202X
Medical Oncology Physician
G84932
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G849320
—
CA
Enumeration date
06/29/2006
Last updated
03/02/2022
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