Individual
DR. LISA J. MAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1215 LEE ST FL 1, CHARLOTTESVILLE, VA 22908-1011
(434) 924-9400
(434) 243-6999
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101261870
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2012
Last updated
02/11/2022
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