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NPI Code Detail

MEDICARE: DR. LISA M TOLIVER

MEDICARE: DR. LISA M TOLIVER
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
1183500000XPharmacistRPH024639GA

General Provider Information

NPI Number : 1992086110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA M TOLIVER
Provider Business Mailing Address
First Line : 3221 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2414
Country : US
Telephone Number : 470-880-1021
Fax Number :
Provider Business Practice Location Address
First Line : 3221 PEACHTREE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2414
Country : US
Telephone Number : 470-880-1021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2011
Last Update Date : 12/30/2025

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