Provider Demographics
NPI:1972665529
Name:LUNEAU, SCOTT MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:MICHAEL
Last Name:LUNEAU
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 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8749
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:
Practice Address - Street 1:15 REGIONAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8850
Practice Address - Country:US
Practice Address - Phone:910-295-5511
Practice Address - Fax:910-420-1616
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245537208M00000X
NC2009-01278208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9043508OtherAETNA
SCN0127BMedicaid
NC153X5OtherBC/BS NC
NC1972665529Medicaid
NCFH1100760OtherFIRSTCAROLINACARE INSURANCE CO
NC5912479Medicaid
SCNO127BOtherSC MEDICAID
NCP01296912OtherPALMETTO GBA RAILROAD MEDICARE
NC153X5OtherBC/BS NC
SCNO127BOtherSC MEDICAID
NCNCC0037AMedicare PIN