Provider Demographics
NPI:1235336579
Name:ROBERT B LAMB, PHD,PC
Entity Type:Organization
Organization Name:ROBERT B LAMB, PHD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-228-8327
Mailing Address - Street 1:1018 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3510
Mailing Address - Country:US
Mailing Address - Phone:906-228-8327
Mailing Address - Fax:906-228-8135
Practice Address - Street 1:1018 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-3510
Practice Address - Country:US
Practice Address - Phone:906-228-8327
Practice Address - Fax:906-228-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301000797103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOE24504OtherBLUE CROSS BLUE SHIELD MI