Provider Demographics
NPI:1568430890
Name:LINDSAY, MARYANNE W (MD)
Entity Type:Individual
Prefix:DR
First Name:MARYANNE
Middle Name:W
Last Name:LINDSAY
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 1:105 ARBORETUM CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8659
Mailing Address - Country:US
Mailing Address - Phone:336-778-2741
Mailing Address - Fax:
Practice Address - Street 1:PEMA
Practice Address - Street 2:3101 LATROBE DRIVE
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211
Practice Address - Country:US
Practice Address - Phone:704-376-7362
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBL4554691207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G15384Medicare UPIN