OrganizationActive
Edward J. Lis, Jr, DO, PLLC
NPI 1578086146 · Orthopaedic Surgery Physician · Fenton, MI
Provider details
- NPI number
- 1578086146
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Laurel Wisniewski, Credentialing/Coding(248) 872-8001
- License
- 5101014456 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17200 Silver Pkwy
Fenton, MI 48430-4437
Phone: (248) 872-8001
Fax: (248) 872-8001
Street-level locationGet directions
Mailing address
Po Box 1855
Clarkston, MI 48347-1855
Registry dates
- Enumerated
- 2017-07-25
- Last updated
- 2017-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.