Healthcare Provider Details

I. General information

NPI: 1538161047
Provider Name (Legal Business Name): LANCASTER SURGICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 W MEETING ST
LANCASTER SC
29720-2205
US

IV. Provider business mailing address

1033 W MEETING ST
LANCASTER SC
29720-2205
US

V. Phone/Fax

Practice location:
  • Phone: 803-286-9762
  • Fax: 803-286-9765
Mailing address:
  • Phone: 803-286-9762
  • Fax: 803-286-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUNIL V LALLA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 803-286-9762