Individual
LISA A DANNEMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1402 BOETTLER RD STE C, UNIONTOWN, OH 44685-9584
(330) 899-0103
(330) 899-0268
Mailing address
1402 BOETTLER RD STE C, UNIONTOWN, OH 44685-9584
(330) 899-0103
(330) 899-0268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35067149D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0786884
MEDICARE ID
OH
05
—
2157357
—
OH
Enumeration date
11/14/2005
Last updated
09/15/2011
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