Provider Demographics
NPI:1881835684
Name:LANE, HENRY CLIFFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:CLIFFORD
Last Name:LANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10 CENTER DRIVE, MSC 1460
Mailing Address - Street 2:CRC 4-1479
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-1460
Mailing Address - Country:US
Mailing Address - Phone:301-496-7196
Mailing Address - Fax:301-480-5560
Practice Address - Street 1:10 CENTER DRIVE, MSC 1460
Practice Address - Street 2:CRC 4-1479
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-1460
Practice Address - Country:US
Practice Address - Phone:301-496-7196
Practice Address - Fax:301-480-5560
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0037848207KI0005X, 207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine