EDWARD J LIS JR. (NPI# 1952371338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952371338 |
| Entity Type | Individual |
| Full Name | EDWARD J LIS JR. |
| Credential | D.O. |
| Practice Address |
6310 Sashabaw Rd Suite A Clarkston MI 48346-2270 |
| Practice Telephone | 2486202325 |
| Practice Fax Number | 2486202326 |
| Mailing Telephone | 2486202325 |
| Mailing Fax Number | 2486202326 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 5101014456 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4623098 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699097220 | Edward Joseph Lis | Pharmacist | 4201 N Harlem Ave, Norridge, IL 60706-1212 | 2010-02-23 |
| Street Address |
6310 SASHABAW RD SUITE A |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346-2270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144694571 | Pine Knob Urgent Care Pllc | Clinic/Center | 6310 Sashabaw Rd, Suite C, Clarkston, MI 48346-2270 | 2015-11-23 |
| 1710271002 | Precision Dna Solutions | Clinical Medical Laboratory | 6310 Sashabaw Rd, Suite D, Clarkston, MI 48346-2270 | 2011-06-03 |
| 1225277304 | Laurie Babcock | Physical Therapist | 6310 Sashabaw Rd, Suite B, Clarkston, MI 48346-2270 | 2009-02-12 |
| 1235338864 | Ross Chiropractic & Wellness PC | Chiropractor | 6310 Sashabaw Rd, Suite B, Clarkston, MI 48346-2270 | 2007-07-13 |
| 1154365708 | Wallace Charles Ross | Chiropractor | 6310 Sashabaw Rd, Suite B, Clarkston, MI 48346-2270 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043480569 | Clayton Stephen Hann | Orthopaedic Surgery | 5621 Glenwood Ct, Clarkston, MI 48346-3108 | 2008-03-12 |
| 1700998226 | Orie Eugene Kaltenbaugh | Orthopaedic Surgery | 3565 Quailridge Dr, Clarkston, WA 99403-1785 | 2006-08-31 |
| 1649241811 | Paul C. Lewis | Orthopaedic Surgery | 6815 Dixie Hwy Ste 1, Clarkston, MI 48346-2092 | 2006-01-27 |
| 1447222468 | Michigan Center for Orthopedic Surgery Plc | Orthopaedic Surgery | 5701 Bow Pointe Dr, Ste 300, Clarkston, MI 48346-3198 | 2006-02-03 |
| 1720058100 | Shivajee V Nallamothu | Orthopaedic Surgery | 5701 Bow Pointe Dr, Suite 300, Clarkston, MI 48346-3198 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805365 | Conner D Ahlgren | Orthopaedic Surgery | 3535 W 13 Mile Rd Ste 742, Royal Oak, MI 48073-6770 | 2020-06-09 |
| 1063035319 | Alex Kane Miller | Orthopaedic Surgery | 3577 W 13 Mile Rd Ste 402, Royal Oak, MI 48073-6710 | 2020-05-21 |
| 1396374716 | Arjun Patel | Orthopaedic Surgery | Ascension Genesys, Gme Dept, One Genesys Pkwy, Grand Blanc, MI 48439-4843 | 2020-04-07 |
| 1346876711 | Timothy Curtis Mead | Orthopaedic Surgery | 4752 Lake Harbor Rd, Norton Shores, MI 49441-5236 | 2020-03-18 |
| 1932751112 | Mendelson Warren Pharmacy | Orthopaedic Surgery | 11900 E 12 Mile Rd Ste 105, Warren, MI 48093-3487 | 2019-07-09 |
| 1023678059 | Th Mg Ohio LLC | Orthopaedic Surgery | 1050 Wilshire Dr Ste 300, Troy, MI 48084-1526 | 2019-06-20 |
| 1609430321 | Mohamed Saad-waterworks, PC | Orthopaedic Surgery | 21031 Michigan Ave Fl 2, Dearborn, MI 48124-2339 | 2019-04-29 |
| 1346804135 | Matthew M Astolfi | Orthopaedic Surgery | 3601 W Thirteenth Mile Road, Royal Oak, MI 48073 | 2019-04-26 |
| 1588228845 | Muhammad Talha Padela | Orthopaedic Surgery | 3990 John R St Ste 7b, Detroit, MI 48201 | 2019-04-23 |
| 1134681125 | Neuro Spine Institute Pllc | Orthopaedic Surgery | 29255 Northwestern Hwy Ste 202, Southfield, MI 48034-5741 | 2019-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.