Individual
GREGORY LAMBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1866 S MOREY RD, LAKE CITY, MI 49651-9190
(231) 775-4841
(231) 839-7222
Mailing address
PO BOX 384, CADILLAC, MI 49601-0384
(231) 775-6076
(231) 775-0027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301036909
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105708412
BLUE CROSS BLUE SHIELD
—
05
—
2092861-10
—
MI
Enumeration date
08/09/2006
Last updated
09/26/2007
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