Provider Demographics
NPI:1467693176
Name:LAMBERT, BRIAN (BOCO)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:BOCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2542
Mailing Address - Country:US
Mailing Address - Phone:586-943-5340
Mailing Address - Fax:586-261-5151
Practice Address - Street 1:2747 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2542
Practice Address - Country:US
Practice Address - Phone:586-943-5340
Practice Address - Fax:586-261-5151
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC26313335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier