Provider Demographics
NPI:1104871599
Name:RING, LISA B (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:RING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:12255 DE PAUL DR
Mailing Address - Street 2:#845
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2530
Mailing Address - Country:US
Mailing Address - Phone:314-344-0004
Mailing Address - Fax:314-344-0631
Practice Address - Street 1:12255 DE PAUL DR
Practice Address - Street 2:#845
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2530
Practice Address - Country:US
Practice Address - Phone:314-344-0004
Practice Address - Fax:314-344-0631
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-10-26
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Provider Licenses
StateLicense IDTaxonomies
MOR9B69207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A09776Medicare UPIN