Lisa G Distefano (NPI# 1003810789, PAC ID# 4183768427) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1003810789 |
| PAC ID by PECOS | 4183768427 |
| Professional Enrollment ID | I20100224000412 |
| Full Name | Lisa G Distefano |
| Organization Legal Name | MOSAIC MEDICAL CENTER - MARYVILLE |
| Address |
2016 S Main St Maryville MO 64468-2655 |
| Phone Number | 6605622525 |
| Gender | F |
| Medical School | TULANE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | PEDIATRIC MEDICINE |
| Group Practice PAC ID | 3678813896 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260050 | SSM HEALTH ST. FRANCIS HOSPITAL- MARYVILLE |
| 260006 | MOSAIC LIFE CARE AT ST JOSEPH |
| Address | Phone | Organization |
|---|---|---|
| 2016 S Main St, Maryville, MO 64468-2655 | 6605622525 | MOSAIC MEDICAL CENTER - MARYVILLE |
| Organization Legal Name | MOSAIC MEDICAL CENTER - MARYVILLE |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake Edward Peterson | Orthopedic Surgery | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Rolando D Breier | Hematology/oncology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Mahmoud B Said | Pathology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Christine Anne Carrejo | Psychiatry | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Brian D Golightly | Emergency Medicine | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Estella M Myrick | Nurse Practitioner | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| William G Humphreys | Orthopedic Surgery | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| David J Stahl | Pathology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Charles Samuel Fillingane Ii | Family Medicine | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Judd M Smith | Orthopedic Surgery | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Street Address |
2016 S MAIN ST |
| City | MARYVILLE |
| State | MO |
| Zip | 64468-2655 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blake Edward Peterson | Orthopedic Surgery | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Rolando D Breier | Hematology/oncology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Sally A Bomar | Family Medicine | Wapiti Medical Group Limited Company | 2016 S Main St, Maryville, MO 64468-2655 |
| Kenton C Freeman | Physical Medicine and Rehabilitation | 2016 S Main St, Maryville, MO 64468-2655 | |
| Mahmoud B Said | Pathology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Christine Anne Carrejo | Psychiatry | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Brian D Golightly | Emergency Medicine | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Estella M Myrick | Nurse Practitioner | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| William G Humphreys | Orthopedic Surgery | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| David J Stahl | Pathology | Mosaic Medical Center - Maryville | 2016 S Main St, Maryville, MO 64468-2655 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michelle Ann Jones | Clinical Social Worker | New Beginnings Counseling Group Inc | 423 N Market St, Maryville, MO 64468-1614 |
| Kristi R White | Clinical Social Worker | New Beginnings Counseling Group Inc | 423 N Market St, Maryville, MO 64468-1614 |
| Danielle Leann Kneib | Clinical Social Worker | Deer Oaks Mental Health Associates PC | 524 N Laura St, Golden Living Center Maryville, Maryville, MO 64468-1955 |
| Kevan J Evans | Chiropractic | Northwest Chiropractic Clinic | 206 W 2nd St, Maryville, MO 64468-2229 |
| Vincent L Shelby | Chiropractic | Northwest Chiropractic Clinic | 206 W 2nd St, Maryville, MO 64468-2229 |
| Darcy Maureen Schieber | Chiropractic | Northwest Chiropractic Clinic | 206 W 2nd St, Maryville, MO 64468-2229 |
| James Dale Schoonover | Chiropractic | Northwest Chiropractic Clinic | 206 W 2nd St, Maryville, MO 64468-2229 |
| Ryan K. Losh | Optometry | 109 S Buchanan St, Maryville, MO 64468-2384 | |
| Leslie Luke | Nurse Practitioner | 106 W Edwards St, Maryville, MO 64468-2419 | |
| Debra Lynne Williams | Optometry | 503 S Main St, Maryville, MO 64468-2444 | |
| Find all physicians in zip 64468 | |||
| City | MARYVILLE |
| Zip Code | 64468 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MARYVILLE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Lisa G Distefano.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.