Provider Demographics
NPI:1245259191
Name:LINCOLN, MICHAEL S (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:LINCOLN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 496
Mailing Address - Street 2:
Mailing Address - City:ANSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28007
Mailing Address - Country:US
Mailing Address - Phone:704-826-8370
Mailing Address - Fax:704-695-1759
Practice Address - Street 1:9191 US HIGHWAY 52 N
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-6290
Practice Address - Country:US
Practice Address - Phone:704-826-8370
Practice Address - Fax:704-826-8016
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200100567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1290FOtherNCBCBS
H48977Medicare UPIN
NCNCA8540281Medicare PIN
H48977Medicare UPIN