Provider Demographics
NPI:1639138688
Name:MCGINNIS, LAMAR SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMAR
Middle Name:SCOTT
Last Name:MCGINNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-4188
Practice Address - Fax:704-384-5299
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93002292085R0001X
SC166692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2086317OtherUNITED HEALTHCARE
NC56552OtherBLUE CROSS
SCN00229Medicaid
NC8956552Medicaid
NC1615495008OtherCIGNA
NC26027OtherPARTNERS
NC62136OtherMEDCOST
NC2086317OtherUNITED HEALTHCARE
NC26027OtherPARTNERS
NC2188359HMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
SCE746726058Medicare ID - Type UnspecifiedSC MEDICARE
NC2188359GMedicare ID - Type UnspecifiedLAKE NORMAN RAD ONC CTR
NC62136OtherMEDCOST
NC2188359FMedicare ID - Type UnspecifiedUNIVERSITY RAD ONC CTR