Basic Information
| Provider Information | |||||||||
| NPI: | 1841237336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARKMAN | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | RACHEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 FRANK LLOYD WRIGHT DR STE J2000 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481059484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347476766 | ||||||||
| FaxNumber: | 7342223100 | ||||||||
| Practice Location | |||||||||
| Address1: | 4350 JACKSON RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349719344 | ||||||||
| FaxNumber: | 7349712303 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 09/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 4301081537 | MI | N | Allopathic & Osteopathic Physicians | Hospitalist | 208000000X | 4301081537 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.