Provider Demographics
NPI:1083617716
Name:LENDLE, DONALD L IX (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:L
Last Name:LENDLE
Suffix:IX
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-759-7596
Mailing Address - Fax:336-759-3652
Practice Address - Street 1:1995 BETHABARA RD
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3375
Practice Address - Country:US
Practice Address - Phone:336-759-7596
Practice Address - Fax:336-759-3652
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC24445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7951670Medicaid
251OtherPARTNERS
2578418OtherAETNA HMO OPOS
58454OtherMEDCOST
287314OtherMAMSI
BCBSOther51670
102267OtherUNITED HEALTHCARE
080118074OtherRAILROAD MEDICARE
NCP00457725OtherRAILROAD MEDICARE
4097828OtherAETNA PPO POS
BCBSOther51670
58454OtherMEDCOST
NC7951670Medicaid
NC340014Medicare Oscar/Certification