MEDICARE: JOHN A LANE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	200500715	NC

General Provider Information

NPI Number	:	1275523177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A LANE MD

Provider Business Mailing Address
First Line	:	2301 REXWOODS DR
Second Line	:	SUITE 114
City	:	RALEIGH
State	:	NC
Zip	:	27607-3366
Country	:	US
Telephone Number	:	919-235-3369
Fax Number	:	919-235-3367

Provider Business Practice Location Address
First Line	:	2301 REXWOODS DR
Second Line	:	SUITE 114
City	:	RALEIGH
State	:	NC
Zip	:	27607-3366
Country	:	US
Telephone Number	:	919-235-3369
Fax Number	:	919-235-3367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	02/20/2013

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Directions to “ JOHN A LANE MD” Practice Location

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