Healthcare Provider Details
I. General information
NPI: 1801805064
Provider Name (Legal Business Name): MICHAEL S LANCASTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2320 HONEYSUCKLE CT
CHAPEL HILL NC
27514-1711
US
IV. Provider business mailing address
2320 HONEYSUCKLE CT
CHAPEL HILL NC
27514-1711
US
V. Phone/Fax
- Phone: 919-942-2857
- Fax:
- Phone: 919-942-2857
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 23050 |
| License Number State | NC |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 50678 |
| Identifier Type | OTHER |
| Identifier State | NC |
| Identifier Issuer | BCBS OF NC |
| # 2 | |
| Identifier | 8950678 |
| Identifier Type | MEDICAID |
| Identifier State | NC |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: