Provider Demographics
NPI:1336464916
Name:LEHMANN, AMBER GAYLE (DO)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:GAYLE
Last Name:LEHMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMUNITY PHYSICIANS OF INDIANA, INC
Mailing Address - Street 2:6626 E. 75TH STREET
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7588
Mailing Address - Fax:
Practice Address - Street 1:7250 CLEARVISTA DR STE 355
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5609
Practice Address - Country:US
Practice Address - Phone:317-621-5676
Practice Address - Fax:317-621-5678
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-02233207R00000X, 208000000X
OH34011340207R00000X, 208000000X, 2080P0204X
IN02005621A207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300026944Medicaid
OH0011227Medicaid
NC1833NOtherBCBS OF NC
INP02268736OtherRRMEDICARE
NC1336464916Medicaid