Organization
MICHAEL W LANE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W LANE MD (OWNER)
(804) 641-6741
Entity
Organization
Contact information
Practice address
95 PINEHILL BLVD, PETERSBURG, VA 23805-9233
(804) 641-6741
(804) 861-0050
Mailing address
PO BOX 3556, PETERSBURG, VA 23805-3556
(804) 641-6741
(804) 861-0050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
VA
Enumeration date
10/27/2006
Last updated
03/05/2008
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