Basic Information
Provider Information
NPI: 1255772588
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMBA
FirstName: VINEET
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.B.,B.S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1407 UNION AVE STE 700
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381043641
CountryCode: US
TelephoneNumber: 9018668003
FaxNumber:  
Practice Location
Address1: 853 JEFFERSON AVE STE 201
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381032804
CountryCode: US
TelephoneNumber: 9014484750
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/15/2013
LastUpdateDate: 06/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2080N0001X58916TNY Allopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine

No ID Information.


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