Healthcare Provider Details

I. General information

NPI: 1376907402
Provider Name (Legal Business Name): SARA KURIAN LAMB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA KURIAN MD

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5921 RILEY PARK DR
FORT SMITH AR
72916-6103
US

IV. Provider business mailing address

1807 CORNELL AVE
RICHMOND VA
23226-3560
US

V. Phone/Fax

Practice location:
  • Phone: 479-649-3376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number0101275436
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD88975
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD048049
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberE-18027
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberE-18027
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: