Provider Demographics
NPI:1992057178
Name:LANCASTER, DREW EDWARD (PA-C)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:EDWARD
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 TRUEMPER ST BLDG 6612
Mailing Address - Street 2:
Mailing Address - City:LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5583
Mailing Address - Country:US
Mailing Address - Phone:210-292-1369
Mailing Address - Fax:
Practice Address - Street 1:18230 E SILVER CREEK AVE STOP 14
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9501
Practice Address - Country:US
Practice Address - Phone:720-847-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
NY023821363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant