Healthcare Provider Details

I. General information

NPI: 1447711148
Provider Name (Legal Business Name): DANIEL AUSTIN LAMBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 DOUG WHITE DR STE 420
MYRTLE BEACH SC
29572-4182
US

IV. Provider business mailing address

920 DOUG WHITE DR STE 420
MYRTLE BEACH SC
29572-4182
US

V. Phone/Fax

Practice location:
  • Phone: 843-497-7772
  • Fax: 843-848-7530
Mailing address:
  • Phone: 843-497-7772
  • Fax: 843-848-7530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number94719
License Number StateSC

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: