| Doctor Name: | EDWARD LISCOMBE |
| NPI Number: | 1003861378 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 5601001946 |
| Business Practice Address: | 1174 W Michigan Ave Marshall, MI - 490681497 |
| Business Phone Number: | 2697819867 |
| Business Fax Number: | 2697819126 |
| Mailing Address: | 111 S Hamilton St, MARSHALL |
| State: | MI |
| Postal Code: | 490681537 |
| Phone Number: | 2697819867 |
| Fax Number: | 2697819126 |
| NPI Enumeration Date: | 05/24/2006 |
| NPI Last Update Date: | 06/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601001946 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |