Provider Demographics
NPI:1386031185
Name:PARKER, LISA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIA
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:VOIGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22250 PROVIDENCE DR STE 606
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6214
Mailing Address - Country:US
Mailing Address - Phone:248-557-9650
Mailing Address - Fax:248-557-5035
Practice Address - Street 1:22250 PROVIDENCE DR STE 606
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6214
Practice Address - Country:US
Practice Address - Phone:248-557-9650
Practice Address - Fax:248-557-5035
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301502404208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery