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NPI 1376626150

NPI 1376626150 : DANIEL STEPHEN LAMBERT PA : LEWISTON, ID

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General NPI Number Information
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    NPI Number           |    1376626150
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL STEPHEN LAMBERT PA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/23/2006
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    Last Update Date     |    09/28/2016
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Provider Practice Location Address
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    Address Line         |    2315 8TH ST 
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    City                 |    LEWISTON
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    State                |    ID
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    Zip                  |    83501-7301
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    Country              |    US
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    Telephone            |    208-746-1383
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    Fax                  |    208-746-6348
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Provider Business Mailing Address
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    Address Line         |    2315 8TH ST 
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    City                 |    LEWISTON
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    State                |    ID
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    Zip                  |    83501-7301
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    Country              |    US
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    Telephone            |    208-746-1383
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    Fax                  |    208-746-6348
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    3802
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    3802
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    License Number State |    AZ
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Taxonomy #3
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA-835
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    License Number State |    ID
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