Provider Demographics
NPI:1275548695
Name:VIENNAS, LAMBROS KONSTANTINOS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMBROS
Middle Name:KONSTANTINOS
Last Name:VIENNAS
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 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8566
Mailing Address - Fax:614-293-3381
Practice Address - Street 1:1800 ZOLLINGER RD FL 3
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-293-8566
Practice Address - Fax:614-293-3381
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD47480174400000X
VA01012452172086S0122X
OH35144123208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherCORVEL/CORCARE (EVMS HEALTH SERVICES)
VA1275548695Medicaid
VAPAROtherAETNA (EVMS HEALTH SERVICES)
VA-019OtherTRICARE/CHAMPUS (EVMS HEALTH SERVICES)
VA10045252OtherSENTARA OPTIMA HEALTH
VA368106OtherANTHEM (EVMS HEALTH SERVICES)
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherUSA MANAGED CARE (EVMS HEALTH SERVICES)
VAPAROtherMULTIPLAN (EVMS HEALTH SERVICES)
VAPAROtherUNITED HEALTH CARE
VAPAROtherCIGNA (EVMS HEALTH SERVICES)
NC5911765Medicaid
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherUSA MANAGED CARE (EVMS HEALTH SERVICES)
VA10045252OtherSENTARA OPTIMA HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK