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Individual

LISA MARIE RAIBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 333-7016
(814) 333-1757
Mailing address
751 LIBERTY ST, MEADVILLE HOSPITALIST SERVICES, MEADVILLE, PA 16335-2559
(814) 333-7016
(814) 333-1757

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS014551
PA
208M00000X
Hospitalist Physician
Primary
OS014551
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT011268
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002064850
HIGHMARK
PA
05
1022492000001
PA
01
412485
UPMC
PA
01
CN1527
RR MEDICARE PTAN
PA
Enumeration date
01/10/2008
Last updated
04/06/2015
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