Healthcare Provider Details

I. General information

NPI: 1356340541
Provider Name (Legal Business Name): LANCE LEE ARNDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9460
US

IV. Provider business mailing address

PO DRAWER 1757
GOLDSBORO NC
27533
US

V. Phone/Fax

Practice location:
  • Phone: 919-734-1866
  • Fax: 919-736-1804
Mailing address:
  • Phone: 919-734-1866
  • Fax: 919-736-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number9600827
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9600827
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number9600827
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4853845-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: