Individual
DR. LOUIS STEPHEN KISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26410 CENTER RIDGE RD, WESTLAKE, OH 44145-4067
(440) 835-6194
(440) 892-9160
Mailing address
PO BOX 40450, BAY VILLAGE, OH 44140-0450
(440) 871-4700
(440) 871-4702
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35-04-4799
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0525560
—
OH
01
—
070000891
MEDICARE RAILROAD PIN
OH
Enumeration date
06/03/2006
Last updated
03/28/2011
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