Individual
DR. ROBERT W LISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 ARLEY WAY, SUITE 201, BLUFFTON, SC 29910-4883
(843) 706-8690
(843) 706-5066
Mailing address
11 ARLEY WAY, SUITE 201, BLUFFTON, SC 29910-4883
(843) 706-8690
(843) 706-5066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32158
SC
207Q00000X
Family Medicine Physician
D14318
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026441500
—
MD
01
—
KJ24GB-41705201
CAREFIRST OF MD GBMC
MD
01
—
S1420009
CAREFIRST REGIONAL GBMC
MD
Enumeration date
06/04/2006
Last updated
11/01/2011
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