1275624397 NPI number — TAMMY LAMB M.D.

Table of content: TAMMY LAMB M.D. (NPI 1275624397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275624397 NPI number — TAMMY LAMB M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMB
Provider First Name:
TAMMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275624397
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2331 BROADBIRCH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20904-1934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-902-1073
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8001 FORBES PL
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22151-2208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-824-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  ME155070 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 0101233562 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300137765 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300137763 . This is a "COMPUTED TOMOGRAPHY ASSOCIATES, RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 114675300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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