Provider Demographics
NPI:1538132162
Name:LAMKE, GEOFFREY T (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:T
Last Name:LAMKE
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 1:14 CANVASBACK PT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1327
Mailing Address - Country:US
Mailing Address - Phone:336-283-0145
Mailing Address - Fax:
Practice Address - Street 1:14 CANVASBACK PT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-1327
Practice Address - Country:US
Practice Address - Phone:336-283-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004008962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I34897OtherUPIN #
NCP00722345OtherMEDICARE RAILROAD
NC141JHOtherBCBS
NC5903931Medicaid
VA1538132162Medicaid