Provider Demographics
NPI:1598991333
Name:IRWIN, LISA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2006 HOGBACK RD
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9750
Mailing Address - Country:US
Mailing Address - Phone:734-786-4989
Mailing Address - Fax:734-786-4977
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR
Practice Address - Street 2:1H247 UNIVERSITY HOSPITAL
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5048
Practice Address - Country:US
Practice Address - Phone:734-936-4280
Practice Address - Fax:734-936-9091
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2017-03-03
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Provider Licenses
StateLicense IDTaxonomies
MI4301094154207L00000X
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program