# MICHAEL W LANE MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114003746
- **Authorized official:** MICHAEL W LANE MD (OWNER)
- **Authorized official phone:** (804) 641-6741

## Contact information

- **Practice address:** 95 PINEHILL BLVD, PETERSBURG, VA 23805-9233
- **Practice address phone:** (804) 641-6741
- **Practice address fax:** (804) 861-0050
- **Mailing address:** PO BOX 3556, PETERSBURG, VA 23805-3556
- **Mailing address phone:** (804) 641-6741
- **Mailing address fax:** (804) 861-0050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 03/05/2008