MEDICARE: LISA M VOLLMER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	41270	MN
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	41270	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558324780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA M VOLLMER MD

Provider Business Mailing Address
First Line	:	910 W 32ND ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-3552
Country	:	US
Telephone Number	:	612-964-1494
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 SMITH AVE N
Second Line	:	STE 600
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-2424
Country	:	US
Telephone Number	:	651-241-7246
Fax Number	:	651-241-7272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	04/25/2025

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Directions to “ LISA M VOLLMER MD” Practice Location

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