MEDICARE: LAMBERT R ABEYATUNGE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	7682	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154439677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMBERT R ABEYATUNGE MD

Provider Business Mailing Address
First Line	:	2255C RENAISSANCE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6751
Country	:	US
Telephone Number	:	702-735-1202
Fax Number	:	702-735-1996

Provider Business Practice Location Address
First Line	:	2255C RENAISSANCE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6751
Country	:	US
Telephone Number	:	702-735-1202
Fax Number	:	702-735-1996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	08/18/2010

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