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General NPI Number Information
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NPI Number | 1619451150
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Entity Type | Individual
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Provider Name | MICHAEL THOMAS LILJEGREN PA
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Gender | Male
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1097 INDUSTRIAL PKWY
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City | SARALAND
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State | AL
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Zip | 36571-3744
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Country | US
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Telephone | 251-375-2270
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Fax | 251-375-2269
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Provider Business Mailing Address
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Address Line | 1097 INDUSTRIAL PKWY
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City | SARALAND
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State | AL
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Zip | 36571-3744
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Country | US
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Telephone | 251-375-2270
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Fax | 251-375-2269
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.1398
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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