Provider Demographics
NPI:1417077454
Name:PARKER, LAMBERT TITUS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMBERT
Middle Name:TITUS
Last Name:PARKER
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 1:5041 CORPORATE WOODS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4375
Mailing Address - Country:US
Mailing Address - Phone:757-226-8880
Mailing Address - Fax:757-226-8883
Practice Address - Street 1:5041 CORPORATE WOODS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4375
Practice Address - Country:US
Practice Address - Phone:757-226-8880
Practice Address - Fax:757-226-8883
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE41068Medicare UPIN