LISA M FLYNN (NPI# 1629070271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629070271 |
| Entity Type | Individual |
| Full Name | LISA M FLYNN |
| Credential | MD |
| Practice Address |
4160 John R Suite 615 Detroit MI 48201-2020 |
| Mailing Address |
1420 Stephenson Hwy Suite 400-credentialing Troy MI 48083-1189 |
| Practice Telephone | 3137454195 |
| Practice Fax Number | 3139938669 |
| Mailing Telephone | 2485815974 |
| Mailing Fax Number | 2485815640 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2013-12-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 4301061622 | MI | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301061622 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518175751 | Lisa Marie Flynn | Registered Nurse | 7938 E Rusty Spur Trl, Prescott Valley, AZ 86314-7808 | 2007-05-20 |
| 1649538034 | Lisa A Flynn | Physician Assistant | 5701 S Hoover St, Los Angeles, CA 90037-4045 | 2012-04-24 |
| Street Address |
4160 JOHN R SUITE 615 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215286976 | Danna Maria Brock | Nurse Practitioner | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2012-09-09 |
| 1346578127 | Ilyes Benchaala | Internal Medicine | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2009-12-07 |
| 1952638272 | Shaun Cardozo | Internal Medicine | 4160 John R, Suite 804, Detroit, MI 48201-2014 | 2009-11-06 |
| 1609000819 | Delorean Q Griffin | Plastic Surgery | 4160 John R, 400, Detroit, MI 48202-2819 | 2009-05-04 |
| 1427228345 | Neather Odessa Libutsi | Social Worker | 4160 John R, Ste 804 Harper Professional Bldg, Detroit, MI 48201 | 2008-03-06 |
| 1871661348 | Ramarao Kaza Md PC | Urology | 4160 John R, Suite 809, Detroit, MI 48201 | 2006-12-01 |
| 1881762334 | Yahya M. Osman-malik | Internal Medicine | 4160 John R, Suite 917, Detroit, MI 48201-2020 | 2006-12-01 |
| 1659448751 | James J Glazier Md PC | Internal Medicine | 4160 John R, Suite 525, Detroit, MI 48201 | 2006-11-30 |
| 1366534232 | Shivkumar Prabhu, M.d., P.C. | Internal Medicine | 4160 John R, Suite 702, Detroit, MI 48201 | 2006-09-29 |
| 1346343449 | Xiaoping Huang | Internal Medicine | 4160 John R, Suite 729, Detroit, MI 48201 | 2006-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437383197 | Barbara D'agnoluzzo Moreira | Surgery | 3663 Woodward Ave Ste 200, Wsu Detroit Medical Center, Detroit, MI 48201-2400 | 2009-05-11 |
| 1083822753 | Yevgeniy Rits | Surgery | 4160 John R #615, Harper Professional Bldg, Detroit, MI 48201-2065 | 2007-05-18 |
| 1740299858 | Paul J. Corcoran | Surgery | 2799 W Grand Blvd # K8, Detroit, MI 48202-2608 | 2006-08-07 |
| 1073992715 | Berg Vascular PC | Surgery | 22101 Moross Rd, Detroit, MI 48236-2148 | 2015-05-27 |
| 1215343553 | Frederick John Jaecklein | Surgery | 4201 Saint Antoine St, 9cuhc, Detroit, MI 48201-2153 | 2014-07-08 |
| 1689091878 | Melanie Schwiesow | Surgery | 311 Mack Ave Ste 64100, Detroit, MI 48201 | 2014-03-25 |
| 1912347279 | Andi Peshkepija | Surgery | 2799 W Grand Blvd # K8, Detroit, MI 48202-2608 | 2013-07-01 |
| 1992915813 | Stavros Kakkos | Surgery | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-05-22 |
| 1518171420 | John W. Sealey, D.o., P.C. | Surgery | 6001 W Outer Dr, Suite 445, Detroit, MI 48235-2614 | 2007-05-09 |
| 1801951637 | Hisham S Bassiouny | Surgery | 2799 W Grand Blvd, Detroit, MI 48202 | 2006-12-22 |
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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.