MEDICARE: DR. LISA M. MOTZ M.D.

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	207R00000X	Internal Medicine Physician	MD068853L	PA

General Provider Information

NPI Number	:	1851394167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA M. MOTZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14623
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-4623
Country	:	US
Telephone Number	:	610-988-8446
Fax Number	:	610-988-4242

Provider Business Practice Location Address
First Line	:	1991 STATE HILL RD
Second Line	:
City	:	WYOMISSING
State	:	PA
Zip	:	19610-1605
Country	:	US
Telephone Number	:	610-988-8480
Fax Number	:	610-988-4242

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/07/2023

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