David Michael Liscow, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301048560 Issued in MI

Practice address

930 Blue Star Hwy
South Haven, MI 49090-7758

Phone

(269) 637-1115

Fax

(269) 639-1314

NPI assigned

Aug 31, 2006

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bronson South Haven Hospital

  dba Bronson Medical Group

  • Family Medicine Physician
  • South Haven, MI
  • NPI 1174749170
  Medicare reassignment NPD
• Bronson South Haven Hospital

  • General Acute Care Hospital
  • South Haven, MI
  • NPI 1346275856
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1689786154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 BLUE STAR HWY",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490907758",
            "telephone_number": "269-637-1115",
            "fax_number": "269-639-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 BLUE STAR HWY",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490907758",
            "telephone_number": "269-637-1115",
            "fax_number": "269-639-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCOW",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301048560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lake Podiatry, PC
• Laura J. Lau, PHARM.D.
• Laurel Oaks of South Haven
• Frederick James Leavitt, DDS
• Lisa Marie Letts, LMT
• Nicholas Loafman, D.O
• Andrea Slifer Loder, M.D.
• Macdonald Drug Store Inc
• Norman M Maly, D.D.S.
• John A Mannik, O.D.

• Family Medicine Physician in South Haven, MI
• Providers in South Haven, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.