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Individual

LUKE RICHARD LISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 347-7111
Mailing address
2602 BLUE CRANE CIR UNIT 104, MYRTLE BEACH, SC 29577-2198

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1356194351
SC

Other

Enumeration date
04/09/2024
Last updated
07/25/2024
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