Provider Demographics
NPI:1265624050
Name:HELMICK, LISA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:HELMICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0286
Mailing Address - Country:US
Mailing Address - Phone:248-338-0100
Mailing Address - Fax:248-977-3014
Practice Address - Street 1:2525 S TELEGRAPH RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0286
Practice Address - Country:US
Practice Address - Phone:248-338-0100
Practice Address - Fax:248-977-3014
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016558207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI160F36364OtherBCBS OF MICHIGAN
MI160F36364OtherBCBS OF MICHIGAN