Healthcare Provider Details

I. General information

NPI: 1467195065
Provider Name (Legal Business Name): THOMAS LAMBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E 20TH ST
SIOUX FALLS SD
57105-1013
US

IV. Provider business mailing address

10831 STATE ROUTE 108
COLUMBIA MD
21044-1338
US

V. Phone/Fax

Practice location:
  • Phone: 605-575-1644
  • Fax:
Mailing address:
  • Phone: 402-913-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: