Individual
DR. LISA MARIE FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
712 PLEASANT ST, PETOSKEY, MI 49770-2841
(231) 489-8060
Mailing address
712 PLEASANT ST, PETOSKEY, MI 49770-2841
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
4301088394
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301088394
MI
Other
Enumeration date
05/28/2007
Last updated
05/14/2025
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