=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457738635
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MATTHEW CHRISTOPHER LAMBERT MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2015
-----------------------------------------------------
Last Update Date | 07/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5359 NOBEL DR
-----------------------------------------------------
City | FITCHBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53711-4972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-263-0946
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5359 NOBEL DR UNIT 226
-----------------------------------------------------
City | FITCHBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53711-4977
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 71281-20
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------