1013998095 NPI number — DR. LISA P. ZWERDLINGER M.D.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	ZWERDLINGER
Provider First Name	:	LISA
Provider Middle Name	:	P.
Provider Name Prefix Text	:	DR.
Provider Name Suffix Text	:
Provider Credential Text	:	M.D.
Provider Gender Code	:	F

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Provider Other First Name	:
Provider Other Middle Name	:
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Provider Other Credential Text	:
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NPI Number	:	1013998095
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	11/20/2009
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	735 US HIGHWAY 24
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	LEADVILLE
Provider Business Mailing Address State Name	:	CO
Provider Business Mailing Address Postal Code	:	804613978
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	7194860500
Provider Business Mailing Address Fax Number	:	7194863966

Provider First Line Business Practice Location Address	:	735 US HIGHWAY 24
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	LEADVILLE
Provider Business Practice Location Address State Name	:	CO
Provider Business Practice Location Address Postal Code	:	804613978
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	7194860500
Provider Business Practice Location Address Fax Number	:	7194863966
Provider Enumeration Date	:	11/08/2005

Authorized Official Last Name	:
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• Taxonomy code: 207Q00000X , with the licence number:  35578 , registered in the state of CO .

• Identifier: C801830 . This identifiers is of the category "".
• Identifier: G39570 , issued by the state of ( CO ) . This identifiers is of the category "".