Individual
DR. ANDREW J LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2936 N ELM ST, LUMBERTON, NC 28358-2981
(919) 684-8111
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
98-00088
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
9800088
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89134XK
—
NC
Enumeration date
10/16/2006
Last updated
07/11/2017
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