Individual
MICHAEL CLARKE LISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-5645
Mailing address
PO BOX 18139, RALEIGH, NC 27619-8139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39298
NC
207R00000X
Internal Medicine Physician
39298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132C1
BCBS NC
NC
01
—
412119
CIGNA
NC
01
—
7008
PARTNERS
NC
01
—
85603
MEDCOST
NC
05
—
89132C1
—
NC
Enumeration date
09/11/2006
Last updated
12/11/2007
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