Provider Demographics
NPI:1992842934
Name:LANCASTER, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:LANCASTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2579 N. SCENIC DR.
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-9784
Mailing Address - Country:US
Mailing Address - Phone:575-446-5100
Mailing Address - Fax:575-446-5134
Practice Address - Street 1:2579 N. SCENIC DR.
Practice Address - Street 2:SUITE B
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-9784
Practice Address - Country:US
Practice Address - Phone:575-446-5100
Practice Address - Fax:575-446-5134
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0387207RE0101X, 207RE0101X
OKOK23569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM301168Medicare PIN