Provider Demographics
NPI:1942418744
Name:LINGERFELT, BRIAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:LINGERFELT
Suffix:
Gender:M
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:PO BOX 751874
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1874
Mailing Address - Country:US
Mailing Address - Phone:843-402-5200
Mailing Address - Fax:
Practice Address - Street 1:2085 HENRY TECKLENBURG DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7710
Practice Address - Country:US
Practice Address - Phone:843-577-6957
Practice Address - Fax:843-577-6523
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD 34441207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC344416Medicaid