Healthcare Provider Details

I. General information

NPI: 1891955969
Provider Name (Legal Business Name): PAUL A. LINGOES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 COLONIAL COMMONS AGAPE PHYSICIANS CARE
LANCASTER SC
29720
US

IV. Provider business mailing address

1624 MAIN STREET AGAPE SENIOR PRIMARY CARE, INC., DBA AGAPE PHYSICIANS C
COLUMBIA SC
29201
US

V. Phone/Fax

Practice location:
  • Phone: 803-207-8200
  • Fax: 803-207-8130
Mailing address:
  • Phone: 803-454-0365
  • Fax: 803-404-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2020-03135
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTL34607
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: