Provider Demographics
NPI:1083727697
Name:LAMBROU, CONSTANTINE G (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:G
Last Name:LAMBROU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 NEWTON STREET
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-742-2500
Mailing Address - Fax:410-546-0621
Practice Address - Street 1:204 NEWTON STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-742-2500
Practice Address - Fax:410-546-0621
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0016607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302131900Medicaid
MDH525F943Medicare PIN
MDD76522Medicare UPIN