Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 34901 | SC |
NPI | 1225390107 |
---|---|
Provider Name | Andrew Scott Lane |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29605-4281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 23/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1225390107 | (05) | VA |
1225390107 | AETNA (01) | VA |
1225390107 | CORVEL (01) | VA |
1225390107 | MULTIPLAN (01) | VA |
1225390107 | TRICARE/CHAMPUS (01) | VA |
1225390107 | VIRGINIA HEALTH NETWORK (01) | VA |
1225390107 | VIRGINIA PREMIER HEALTH PLAN (01) | VA |