Provider Demographics
NPI:1215215934
Name:ENTZMINGER, LAKESHIA ANTOINETTE (MD)
Entity Type:Individual
Prefix:
First Name:LAKESHIA
Middle Name:ANTOINETTE
Last Name:ENTZMINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 HARDEN ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-7516
Mailing Address - Country:US
Mailing Address - Phone:336-698-3500
Mailing Address - Fax:336-698-3814
Practice Address - Street 1:378 HARDEN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-7516
Practice Address - Country:US
Practice Address - Phone:336-698-3500
Practice Address - Fax:336-698-3814
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116027867207RH0002X, 207RG0300X
NC2019-00968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine