Provider Demographics
NPI:1558456327
Name:KAMBHAMETTU, LALITHA (MD)
Entity Type:Individual
Prefix:
First Name:LALITHA
Middle Name:
Last Name:KAMBHAMETTU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DOMINIC DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1447
Mailing Address - Country:US
Mailing Address - Phone:302-287-7506
Mailing Address - Fax:
Practice Address - Street 1:102 DOMINIC DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1447
Practice Address - Country:US
Practice Address - Phone:302-287-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine