Provider Demographics
NPI:1740200856
Name:SWEENEY, LANCE C (DO)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:C
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5420 US HIGHWAY 70 W
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4510
Mailing Address - Country:US
Mailing Address - Phone:252-240-2349
Mailing Address - Fax:252-240-1840
Practice Address - Street 1:5420 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4510
Practice Address - Country:US
Practice Address - Phone:252-240-2349
Practice Address - Fax:252-240-1840
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME1873207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1740200856Medicaid
MEME131701Medicare PIN