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General NPI Number Information
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NPI Number | 1942273305
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Entity Type | Individual
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Provider Name | PAUL VICTOR LISZKA MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 1200 J D ANDERSON DR
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City | MORGANTOWN
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State | WV
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Zip | 26505-3494
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Country | US
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Telephone | 304-598-1200
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Fax | 304-598-1699
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Provider Business Mailing Address
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Address Line | PO BOX 2546
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City | VIRGINIA BEACH
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State | VA
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Zip | 23450-2546
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Country | US
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Telephone | 757-340-3489
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Fax | 757-340-4278
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D89720
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25805
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 0101237151
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License Number State | VA
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