Healthcare Provider Details

I. General information

NPI: 1073644175
Provider Name (Legal Business Name): WENDY S LANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 ASHELAND AVE
ASHEVILLE NC
28801
US

IV. Provider business mailing address

122 WINDOVER DR
ASHEVILLE NC
28803
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-2404
  • Fax: 828-258-0864
Mailing address:
  • Phone: 828-684-8843
  • Fax: 828-258-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number9800602
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number9800602
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: