Provider Demographics
NPI:1831185107
Name:LISCHER, GARRETT HENRY (MD)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:HENRY
Last Name:LISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 GRAND CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9245 PARK WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4425
Practice Address - Country:US
Practice Address - Phone:865-690-3811
Practice Address - Fax:865-694-7621
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38324208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0347510001OtherMEDICARE NSC
TN3892882Medicaid
P00154012Medicare PIN
TN0347510001OtherMEDICARE NSC
3892882Medicare UPIN