Provider Demographics
NPI:1972500825
Name:LEMASTER, PIERRE CLIFFORD (MD)
Entity type:Individual
Prefix:
First Name:PIERRE
Middle Name:CLIFFORD
Last Name:LEMASTER
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 1:1291 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4450
Mailing Address - Country:US
Mailing Address - Phone:910-483-2646
Mailing Address - Fax:910-483-9470
Practice Address - Street 1:1291 OLIVER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4450
Practice Address - Country:US
Practice Address - Phone:910-483-2646
Practice Address - Fax:910-483-9470
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20157208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC51654OtherBLUE CROSS BLUE SHIELD
NC51654OtherBLUE CROSS BLUE SHIELD