Basic Information
Provider Information
NPI: 1801891650
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCLAMB
FirstName: DONALD
MiddleName: LEE
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4402 SHIPYARD BLVD
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284036161
CountryCode: US
TelephoneNumber: 9102023363
FaxNumber: 9103321072
Practice Location
Address1: 4402 SHIPYARD BLVD
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284036161
CountryCode: US
TelephoneNumber: 9104521400
FaxNumber: 9103321072
Other Information
ProviderEnumerationDate: 06/17/2005
LastUpdateDate: 09/01/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X200300382NCY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
P0005781201NCRAILROAD MEDICAREOTHER
Q0038E05SC MEDICAID
C630101NCMEDCOSTOTHER
P0013021101NCRAILROAD MEDICAREOTHER
134CX01NCBCBSOTHER
39-0133501NCUNITED HEALTHCAREOTHER
89134CX05NC MEDICAID


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