Individual
LISA MICHELLE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
7804 FAIRVIEW RD STE A, CHARLOTTE, NC 28226-4999
(704) 316-3136
(704) 316-3140
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-3136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101249355
VA
207Q00000X
Family Medicine Physician
Primary
2014-01731
NC
207Q00000X
Family Medicine Physician
A78186
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00621284
MEDICARE RAIL ROAD
CA
Enumeration date
07/28/2006
Last updated
04/12/2023
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