Individual
DIANA LISHNEVSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 PARK CENTER DR STE 304, WADSWORTH, OH 44281-9482
(330) 336-3631
(330) 336-3762
Mailing address
1 PARK CENTER DR STE 304, WADSWORTH, OH 44281-9482
(330) 336-3631
(330) 336-3762
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35091273
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2840555
—
OH
01
—
4243052
MEDICARE ID
—
Enumeration date
05/02/2007
Last updated
08/15/2011
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