Healthcare Provider Details

I. General information

NPI: 1992842934
Provider Name (Legal Business Name): ANDREW LANCASTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DREW LANCASTER

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2579 N. SCENIC DR. SUITE B
ALAMOGORDO NM
88310-9784
US

IV. Provider business mailing address

2579 N. SCENIC DR.
ALAMOGORDO NM
88310-9784
US

V. Phone/Fax

Practice location:
  • Phone: 575-446-5100
  • Fax: 575-446-5134
Mailing address:
  • Phone: 575-446-5100
  • Fax: 575-446-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD2008-0387
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: