Dr David Michael Liscow, MD | |
930 Blue Star Hwy, South Haven, MI 49090-7758 | |
(269) 637-1115 | |
(269) 639-1314 |
Full Name | Dr David Michael Liscow |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 930 Blue Star Hwy, South Haven, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689786154 | NPI | - | NPPES |
080H06004 | Other | MI | BCBSM |
080027374 | Other | MI | RR MEDICARE |
1656193 | Medicaid | MI | |
0131169 | Other | MI | PHP/IBA |
P53524 | Other | MI | BCN |
5468088 | Other | MI | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301048560 (Michigan) | Primary |
Entity Name | Bronson South Haven Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174749170 PECOS PAC ID: 6204724834 Enrollment ID: O20040305001005 |
Mailing Address | Practice Location Address |
---|---|
Dr David Michael Liscow, MD 930 Blue Star Hwy, South Haven, MI 49090-7758 Ph: (269) 637-1115 | Dr David Michael Liscow, MD 930 Blue Star Hwy, South Haven, MI 49090-7758 Ph: (269) 637-1115 |
Conor Mullin, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 930 Blue Star Hwy, South Haven, MI 49090 Phone: 269-637-1115 | |
Dr. Arlynne Mildred Eisner, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 955 S Bailey Ave, South Haven, MI 49090 Phone: 269-427-5811 Fax: 269-427-6107 | |
Dr. Gordon R Bleil, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 955 S Bailey Ave, South Haven, MI 49090 Phone: 269-639-2910 Fax: 269-639-2919 | |
Dr. Matthew G Small, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 965 S Bailey Ave, Suite 2-1, South Haven, MI 49090 Phone: 269-639-2772 Fax: 269-639-2770 | |
Dr. Richard John Allen, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 930 Blue Star Hwy, South Haven, MI 49090 Phone: 269-637-1115 Fax: 269-639-1314 | |
Dr. Martin J Graber Jr., M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 31 Lincoln Ave, South Haven, MI 49090 Phone: 616-334-1245 Fax: 269-637-1021 | |
Kathy Watt, N.P. Family Medicine Medicare: Medicare Enrolled Practice Location: 930 Blue Star Hwy, South Haven, MI 49090 Phone: 269-637-1115 |