Provider Demographics
NPI:1275153363
Name:MARSHALL, LISA (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2025 SLOAN PL STE 35
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2092
Mailing Address - Country:US
Mailing Address - Phone:651-772-1572
Mailing Address - Fax:651-772-1889
Practice Address - Street 1:2980 BUCKLEY WAY
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-2017
Practice Address - Country:US
Practice Address - Phone:651-457-2748
Practice Address - Fax:651-457-0822
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2023-06-09
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Provider Licenses
StateLicense IDTaxonomies
MN70007207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine