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DR. HESTON CHANNING LAMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1612 AZALEA DR, WILMINGTON, NC 28403-4860
(910) 538-4009
(910) 335-8967
Mailing address
1612 AZALEA DR, WILMINGTON, NC 28403-4860
(910) 538-4009
(910) 335-8967

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101274846
VA
207P00000X
Emergency Medicine Physician
Primary
200401250
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138M8
BCBS
NC
05
5901260
NC
01
E3576
MEDCOST
NC
01
P00247883
RAILROAD MEDICARE
NC
01
P00328065
RAILROAD MEDICARE
NC
05
Q0125A
SC
Enumeration date
06/17/2005
Last updated
02/16/2025
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