MEDICARE: LAMBERT R ABEYATUNGE MD FACS PROFESSIONAL CORPORATION

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

General Provider Information

NPI Number	:	1861500399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAMBERT R ABEYATUNGE MD FACS PROFESSIONAL CORPORATION

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	:	PRESIDENT
Name	:	LAMBERT ABEYATUNGE
Credential	:	MD
Telephone Number	:	702-735-1202

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

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