Provider Demographics
NPI:1467763870
Name:LAMP, CLYDE B JR (MD)
Entity Type:Individual
Prefix:
First Name:CLYDE
Middle Name:B
Last Name:LAMP
Suffix:JR
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 1:107 YORKSHIRE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2417
Mailing Address - Country:US
Mailing Address - Phone:412-963-0588
Mailing Address - Fax:
Practice Address - Street 1:107 YORKSHIRE DRIVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2417
Practice Address - Country:US
Practice Address - Phone:412-963-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021293L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology