Individual
LISA MARIE ROSHETSKY KEARNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
660 LONDON AVE STE A, MARYSVILLE, OH 43040-1515
(937) 642-1550
(937) 578-2821
Mailing address
660 LONDON AVE STE A, MARYSVILLE, OH 43040-1515
(937) 642-1550
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35093936
OH
207R00000X
Internal Medicine Physician
MD040679
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2966401
—
OH
Enumeration date
03/29/2007
Last updated
01/06/2023
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