Individual
LISA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3290
Mailing address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3290
(269) 387-2944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301063889
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C94735
BLUE CROSS BLUE SHIELD
MI
05
—
4950458
—
MI
Enumeration date
05/24/2006
Last updated
12/09/2008
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