Individual
MATTHEW LISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 BLYTHE BLVD, SUITE 200D, CHARLOTTE, NC 28203-5866
(704) 373-1813
Mailing address
1001 BLYTHE BLVD, CHARLOTTE, NC 28203-5866
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2016-01243
NC
Other
Enumeration date
04/15/2009
Last updated
11/08/2018
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