Provider Demographics
NPI:1598749186
Name:TROYER, LISA R (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:TROYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:P O BOX 741030
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1030
Mailing Address - Country:US
Mailing Address - Phone:804-560-5827
Mailing Address - Fax:804-560-5845
Practice Address - Street 1:1401 JOHNSTON WILLIS DR STE 5500
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-560-5827
Practice Address - Fax:804-560-5845
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055080207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598749186Medicaid
VAE57614Medicare UPIN
VAVAA113148Medicare PIN