MEDICARE: DR. STEPHEN K LANE MD

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
1	207Q00000X	Family Medicine Physician	203507	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	710899	OTHER	MA	HPHC
3	203507	OTHER		TUFTS
4	J23581	OTHER	MA	BCBS
5	0103663	OTHER		UNITED
6	2459036	OTHER		CIGNA

General Provider Information

NPI Number	:	1871584094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN K LANE MD

Provider Business Mailing Address
First Line	:	56 NEW DRIFTWAY
Second Line	:	SUITE 301
City	:	SCITUATE
State	:	MA
Zip	:	02066-4533
Country	:	US
Telephone Number	:	781-544-1388
Fax Number	:	781-544-3396

Provider Business Practice Location Address
First Line	:	56 NEW DRIFTWAY
Second Line	:	SUITE 301
City	:	SCITUATE
State	:	MA
Zip	:	02066-4533
Country	:	US
Telephone Number	:	781-544-1388
Fax Number	:	781-544-3396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/19/2010

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Directions to “ DR. STEPHEN K LANE MD” Practice Location

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