Healthcare Provider Details

I. General information

NPI: 1780003558
Provider Name (Legal Business Name): ACACIA LAMB M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-9982
US

IV. Provider business mailing address

36 FREEDOM RD
SCARBOROUGH ME
04074-9663
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7293
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD26272
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1013205
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: