Individual
STEFAN LISCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 FISHER RD, MOB-A, SUITE 2-1, BERLIN, VT 05602-9516
(802) 225-5660
(802) 229-9533
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 225-5660
(802) 229-9533
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
042.0012827
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023254
—
VT
Enumeration date
07/02/2008
Last updated
07/18/2014
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