Basic Information
| Provider Information | |||||||||
| NPI: | 1033144357 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACHIN | ||||||||
| FirstName: | LISSETTE | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 FIRST VILLAGE DRIVE | ||||||||
| Address2: | PO BOX 2000 | ||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956831 | ||||||||
| FaxNumber: | 9102950244 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 FIRST VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283748724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956831 | ||||||||
| FaxNumber: | 9102950876 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 10/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2008-01141 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 5910619 | 05 | NC | MEDICAID | 8956617 | 01 | NC | CIGNA HEALTHCARE | OTHER |