Individual
DR. LISA BRANCAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 COLLIERS WAY, LAB, WEIRTON, WV 26062-5014
(304) 797-6332
Mailing address
PO BOX 2288, WEIRTON, WV 26062-1488
(304) 797-6332
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20178
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2316694
—
OH
05
—
6600217000
—
WV
Enumeration date
10/13/2005
Last updated
07/08/2007
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