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General NPI Number Information
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NPI Number | 1023231099
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Entity Type | Individual
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Provider Name | LINDSEY DANIELLE LIRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 27082 W MAIN ST
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City | EDWARDSBURG
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State | MI
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Zip | 49112-9334
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Country | US
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Telephone | 269-246-1375
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Fax | 269-246-1376
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Provider Business Mailing Address
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Address Line | 27082 W. MAIN ST
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City | EDWARDSBURG
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State | MI
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Zip | 49112-9334
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Country | US
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Telephone | 269-246-1375
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Fax | 269-246-1376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01063930A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301103983
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License Number State | MI
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