Healthcare Provider Details

I. General information

NPI: 1043860570
Provider Name (Legal Business Name): MEGAN E LAMBERTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN E SHEA PA

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-6723
  • Fax: 414-955-6210
Mailing address:
  • Phone: 414-955-6723
  • Fax: 414-955-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4903-023
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number10004126A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: