Provider Demographics
NPI:1972535375
Name:LAW, INGER M (MD)
Entity type:Individual
Prefix:
First Name:INGER
Middle Name:M
Last Name:LAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S. VAN BUREN RD.
Mailing Address - Street 2:SUITE-2
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-627-5437
Mailing Address - Fax:336-627-1681
Practice Address - Street 1:520 S. VAN BUREN RD.
Practice Address - Street 2:SUITE-2
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5201
Practice Address - Country:US
Practice Address - Phone:336-627-5437
Practice Address - Fax:336-627-1681
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC96-01125208000000X
NC9601125208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951172Medicaid
NC8951172Medicaid