Provider Demographics
NPI:1003885740
Name:TEIGLAND, LILLIAN M (MD)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:M
Last Name:TEIGLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:
Other - Last Name:MCKAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:704-384-7830
Practice Address - Street 1:6324 FAIRVIEW RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3271
Practice Address - Country:US
Practice Address - Phone:704-384-0588
Practice Address - Fax:704-384-0580
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8982344Medicaid
SCN31663Medicaid
NC82344OtherBCBS OF NC
NC8982344Medicaid
SCN31663Medicaid