Provider Demographics
NPI:1700951456
Name:HAWES, LISA NIPKOW (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:NIPKOW
Last Name:HAWES
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Gender:F
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:443-738-2872
Mailing Address - Fax:443-738-2713
Practice Address - Street 1:7625 MAPLE LAWN BLVD
Practice Address - Street 2:# 210
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:301-725-0134
Practice Address - Fax:301-725-0135
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2013-01-17
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Provider Licenses
StateLicense IDTaxonomies
MDD0061157208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I02902Medicare UPIN
MDKK88C629Medicare PIN
MD230645YZUMedicare PIN