Individual
DR. MICHAEL KEITH LICHTMAN
Active
Individual
DR. MICHAEL KEITH LICHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
237195
MA
207N00000X
Dermatology Physician
Primary
DR.0058361
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027998
KAISER COMMERCIAL NUMBER
CO
05
—
110083961A
—
MA
01
—
BP1-0026117
INSTITUTIONAL PERMIT
—
Enumeration date
05/31/2007
Last updated
07/21/2022
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