Healthcare Provider Details

I. General information

NPI: 1730148644
Provider Name (Legal Business Name): MARY PARKS LAMB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 WASHINGTON RD STE 100
MC MURRAY PA
15317-6408
US

IV. Provider business mailing address

3323 WASHINGTON RD STE 100
MC MURRAY PA
15317-6408
US

V. Phone/Fax

Practice location:
  • Phone: 724-969-5262
  • Fax: 724-821-9700
Mailing address:
  • Phone: 724-969-5262
  • Fax: 724-821-9700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD062991L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD062291L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier000974412
Identifier TypeOTHER
Identifier State
Identifier IssuerHIGHMARK
# 2
Identifier103132
Identifier TypeOTHER
Identifier State
Identifier IssuerUPMC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: