Provider Demographics
NPI:1225099898
Name:LAMBRIX, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:LAMBRIX
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 1:2218 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:TEKONSHA
Mailing Address - State:MI
Mailing Address - Zip Code:49092-9261
Mailing Address - Country:US
Mailing Address - Phone:517-767-4038
Mailing Address - Fax:517-767-3427
Practice Address - Street 1:2218 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:TEKONSHA
Practice Address - State:MI
Practice Address - Zip Code:49092-9261
Practice Address - Country:US
Practice Address - Phone:517-767-4038
Practice Address - Fax:517-767-3427
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDL036704207Q00000X
MI4301036704207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1637699Medicaid
MI0131108Medicare PIN
MI1637699Medicaid