Individual
FREDERIC ELIOT LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MAIN ST, PHOENIXVILLE, PA 19460-3810
(610) 935-1120
(610) 935-5507
Mailing address
833 CHESTNUT ST, SUITE 1402, PHILADELPHIA, PA 19107-4414
(800) 321-9999
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MA09448300
NJ
207X00000X
Orthopaedic Surgery Physician
Primary
MD036317E
PA
207XS0106X
Orthopaedic Hand Surgery Physician
MD036317E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1292527
—
PA
Enumeration date
06/22/2005
Last updated
11/10/2015
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