Organization
LUMBERTON ANESTHESIA CONSULTANTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL G. KIDD M.D. (PRESIDENT)
(910) 738-8154
Entity
Organization
Contact information
Practice address
2905 N ELM ST, LUMBERTON, NC 28358-2982
(910) 738-8154
(910) 671-8818
Mailing address
2905 N ELM ST, P O BOX 2370, LUMBERTON, NC 28358-2982
(910) 738-8154
(910) 671-8818
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176G
BLUE CROSS BLUE SHIELD
NC
05
—
890176G
—
NC
01
—
CI4206
MEDICARE ID - RAILROAD
NC
Enumeration date
02/08/2006
Last updated
02/04/2010
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