Provider Demographics
NPI:1891955969
Name:LINGOES, PAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:LINGOES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1624 MAIN STREET
Mailing Address - Street 2:AGAPE SENIOR PRIMARY CARE, INC., DBA AGAPE PHYSICIANS C
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-454-0365
Mailing Address - Fax:803-404-6000
Practice Address - Street 1:1201 COLONIAL COMMONS
Practice Address - Street 2:AGAPE PHYSICIANS CARE
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720
Practice Address - Country:US
Practice Address - Phone:803-207-8200
Practice Address - Fax:803-207-8130
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2023-07-17
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2020-03135207Q00000X
SCTL34607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC127OtherRHC MEDICAID (LANCASTER)
SCRHC211OtherRHC MEDICAID (INDIANLAND)
SC428960OtherRHC MEDICARE (LANCASTER)
SCCE1315OtherMEDICARE RAILROAD GROUP#
SCGP0641Medicaid
SC346076OtherINDIVIDUAL MEDICAID PROVIDER
SC423876OtherRHC MEDICARE (INDIANLAND)
SC428960OtherRHC MEDICARE (LANCASTER)