Lysne, Dwight H

Lysne, Dwight H is an individual health care provider with primary practice located at 20 S 16Th St , Wilmington NC 28401-4924. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Lysne, Dwight H can be contacted via phone (877) 456-6729.

Contact Information

Primary practice address
20 S 16Th St Wilmington NC 28401-4924
Phone: (877) 456-6729
Fax: (910) 399-3928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 5512 North Dakota
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 28290 Minnesota
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 200301378 North Carolina

Profile Details

NPI number 1083679062
LBN Legal business name Lysne, Dwight H
Credentials MD, MDIV
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Sep 26th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083679062 NPPES
Minnesota Other 94D78LY MNBC/BS
Minnesota MEDICAID 15992 MNBC/BS
Minnesota MEDICAID 937078100 MNBC/BS
Minnesota Other 19977 MNBC/BS
Minnesota Other 260045000 MNBC/BS
Minnesota MEDICAID 891378J MNBC/BS

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