Individual
LISA K HIGGINBOTHAM
Active
Individual
LISA K HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD453969
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103054240
—
PA
01
—
61131403 S108NE
CAREFIRST BLUE SHIELD
MD
05
—
904001300
—
MD
01
—
F288 0008
GHMSI
—
01
—
P00026790
RAILROAD MEDICARE
MD
Enumeration date
05/17/2006
Last updated
07/15/2024
Update your record
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