Basic Information
| Provider Information | |||||||||
| NPI: | 1740211226 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATIVE PHYSICIANS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 ACADEMY RD | ||||||||
| Address2: | #200 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277072660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194038600 | ||||||||
| FaxNumber: | 9194898585 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 ACADEMY RD | ||||||||
| Address2: | #200 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277072660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194038600 | ||||||||
| FaxNumber: | 9194898585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 10/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | LEHR | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9194038600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 790134H | 05 | NC | MEDICAID | 0134H | 01 | NC | BCBS | OTHER |