Provider Demographics
NPI:1093880379
Name:LULL, LISA SCHILLER (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:SCHILLER
Last Name:LULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:GAIL
Other - Last Name:SCHILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8001 FORBES PL STE 103
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2205
Mailing Address - Country:US
Mailing Address - Phone:703-824-3210
Mailing Address - Fax:703-321-3300
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE289802085R0202X
AL000267572085R0202X
CO00559722085R0202X
TN449172085R0202X
MDD00669192085R0202X
WY10394A2085R0202X
WV278452085R0202X
VA01012632772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology