MEDICARE: DR. LAMBERT TITUS PARKER 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	207R00000X	Internal Medicine Physician	0101232844	VA

General Provider Information

NPI Number	:	1417077454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAMBERT TITUS PARKER MD

Provider Business Mailing Address
First Line	:	5041 CORPORATE WOODS DR
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4375
Country	:	US
Telephone Number	:	757-226-8880
Fax Number	:	757-226-8883

Provider Business Practice Location Address
First Line	:	5041 CORPORATE WOODS DR
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4375
Country	:	US
Telephone Number	:	757-226-8880
Fax Number	:	757-226-8883

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

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	07/08/2007

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