Individual
DR. LISA FOGEL MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2605 BLUE RIDGE RD STE 320, RALEIGH, NC 27607-6475
(919) 787-8555
(919) 787-8112
Mailing address
2605 BLUE RIDGE RD STE 320, RALEIGH, NC 27607-6475
(919) 787-8555
(919) 787-8112
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2006-00726
NC
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
2006-00726
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903995
—
NC
Enumeration date
07/13/2005
Last updated
11/23/2023
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