Individual
DR. ZACHARY JONATHAN LISS
Active
Individual
DR. ZACHARY JONATHAN LISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
4301092867
MI
2088P0231X
Pediatric Urology Physician
Primary
4301092867
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340E062730
BCBSM
MI
01
—
CB9133
RAILROAD MEDICARE
MI
Enumeration date
03/12/2009
Last updated
08/06/2015
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