Individual
DR. TIMOTHY WALTER LANE
Active
Individual
DR. TIMOTHY WALTER LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22588
NC
207RI0200X
Infectious Disease Physician
Primary
22588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26776
MEDCOST
NC
01
—
3595
PARTNERS MEDICARE CHOICE
NC
01
—
4316181
AETNA
NC
01
—
50794
BCBS NC
NC
05
—
8950794
—
NC
Enumeration date
06/01/2006
Last updated
12/11/2012
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