Provider Demographics
NPI:1487775292
Name:SCHEEL, LISA BETH (DO)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:SCHEEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4154 S RIVER RD
Mailing Address - Street 2:BUILDING #2
Mailing Address - City:EAST CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2925
Mailing Address - Country:US
Mailing Address - Phone:810-329-2350
Mailing Address - Fax:810-329-2695
Practice Address - Street 1:4150 S RIVER RD STE E
Practice Address - Street 2:
Practice Address - City:EAST CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-2915
Practice Address - Country:US
Practice Address - Phone:810-329-1228
Practice Address - Fax:810-329-1280
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1487775292Medicaid
MI1487775292Medicaid