Individual
ROBERT PHILIP LISAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 ST ANTOINE, SUITE 8A & 8B, DETROIT, MI 48201-2153
(313) 745-4275
(313) 745-4468
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(313) 745-4275
(313) 745-4468
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301051038
MI
Other
Enumeration date
06/01/2006
Last updated
10/27/2016
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