Individual
LISA PARKE MAIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6800 STATE ROUTE 162, DEPARTMENT OF EMERGENCY MEDICINE, MARYVILLE, IL 62062-8500
(618) 288-5711
Mailing address
6800 STATE ROUTE 162, DEPARTMENT OF EMERGENCY MEDICINE, MARYVILLE, IL 62062-8500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.119597
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119597-3
—
IL
05
—
1255503587
—
MO
Enumeration date
03/27/2008
Last updated
07/19/2011
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