Individual
LISA L DEWINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 S MILL AVE, TEMPE, AZ 85281
(517) 304-0652
Mailing address
5750 E OLD PAINT TRAIL, CAREFREE, AZ 85377
(517) 304-0652
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
060204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3433240
—
MI
01
—
LW060204
BC/BS
MI
Enumeration date
05/28/2006
Last updated
03/16/2017
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