Provider Demographics
NPI:1902378185
Name:SLISHER, MARIE DAWN (PA)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:DAWN
Last Name:SLISHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3160
Mailing Address - Country:US
Mailing Address - Phone:517-612-5114
Mailing Address - Fax:
Practice Address - Street 1:130 N SHERMAN ST
Practice Address - Street 2:
Practice Address - City:LESLIE
Practice Address - State:MI
Practice Address - Zip Code:49251-9409
Practice Address - Country:US
Practice Address - Phone:517-205-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical