Individual
MARK LAMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
(317) 745-5403
Mailing address
8607 E US HIGHWAY 36 STE 100, AVON, IN 46123-7960
(317) 745-5403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045336A
IN
363L00000X
Nurse Practitioner
71005791A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200171710
—
IN
Enumeration date
10/11/2006
Last updated
03/23/2021
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