Individual
DR. TIMOTHY WALTER LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 E WENDOVER AVE, SUITE 111, GREENSBORO, NC 27401-1230
(336) 832-7840
(336) 832-3285
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
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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