Basic Information
Provider Information
NPI: 1710948468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMB
FirstName: EILEEN
MiddleName: O
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1551 WALL ST
Address2: SUITE 310
City: SAINT CHARLES
State: MO
PostalCode: 633033539
CountryCode: US
TelephoneNumber: 6366692268
FaxNumber: 6366692401
Practice Location
Address1: 2730 S HIGHWAY 94
Address2:  
City: SAINT PETERS
State: MO
PostalCode: 633035677
CountryCode: US
TelephoneNumber: 6364477821
FaxNumber: 6366692401
Other Information
ProviderEnumerationDate: 03/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207QA0505XR8627MOX Allopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
207R00000XR8627MOX Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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