Provider Demographics
NPI:1194059196
Name:AWAN, LISA BAHIGA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:BAHIGA
Last Name:AWAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:18101 OAKWOOD BLVD
Mailing Address - Street 2:OAKWOOD HOSPITAL & MEDICAL CENTER, MEDICAL EDUCATION
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-436-2581
Mailing Address - Fax:
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:OAKWOOD HOSPITAL & MEDICAL CENTER, MEDICAL EDUCATION
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-436-2581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010952202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology