Provider Demographics
NPI:1114981339
Name:LISCHKE, AIMEE JOY (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:JOY
Last Name:LISCHKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1665 WESTBROOK PLAZA DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2993
Practice Address - Country:US
Practice Address - Phone:336-760-8380
Practice Address - Fax:336-760-8388
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-01463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891231GMedicaid
NCP00839207OtherRR MEDICARE
NC011PROtherBCBS
NC891231GMedicaid
NCH00161Medicare UPIN
NC2272876BMedicare PIN