Provider Demographics
NPI:1366896540
Name:LISA M SAVOIE, MD, LLC
Entity type:Organization
Organization Name:LISA M SAVOIE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAVOIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-632-7482
Mailing Address - Street 1:10 FILA WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9452
Mailing Address - Country:US
Mailing Address - Phone:443-421-5550
Mailing Address - Fax:
Practice Address - Street 1:10 FILA WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9452
Practice Address - Country:US
Practice Address - Phone:443-421-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047429208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty