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Individual

DR. STEVEN JULIUS LISSAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5240 S EASTERN AVE, LAS VEGAS, NV 89119-2306
(702) 480-4006
(702) 736-8889
Mailing address
5240 S EASTERN AVE, LAS VEGAS, NV 89119-2306
(702) 480-4006
(702) 736-8889

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6072
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CC8251
BLUE CROSS/BLUE SHIELD
NV
Enumeration date
07/13/2006
Last updated
08/13/2007
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