Basic Information
| Provider Information | |||||||||
| NPI: | 1568430890 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINDSAY | ||||||||
| FirstName: | MARYANNE | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 ARBORETUM CT | ||||||||
| Address2: | |||||||||
| City: | LEWISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270238659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367782741 | ||||||||
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| Practice Location | |||||||||
| Address1: | PEMA | ||||||||
| Address2: | 3101 LATROBE DRIVE | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043767362 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2006 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | BL4554691 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.