Healthcare Provider Details

I. General information

NPI: 1750449112
Provider Name (Legal Business Name): SEAN JOSEPH LAMBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NORTHSIDE FORSYTH DR SUITE 350
CUMMING GA
30041-8416
US

IV. Provider business mailing address

1800 NORTHSIDE FORSYTH DR SUITE 350
CUMMING GA
30041-8416
US

V. Phone/Fax

Practice location:
  • Phone: 770-886-3555
  • Fax: 770-205-6501
Mailing address:
  • Phone: 770-886-3555
  • Fax: 770-205-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number030336
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: