Provider Demographics
NPI:1598734766
Name:LAMBERT, ERIC BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRIAN
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 KENMOOR AVE SE STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8627
Mailing Address - Country:US
Mailing Address - Phone:616-956-1112
Mailing Address - Fax:616-956-6265
Practice Address - Street 1:751 KENMOOR AVE SE STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8627
Practice Address - Country:US
Practice Address - Phone:616-956-1111
Practice Address - Fax:616-956-6265
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDF3289OtherPALMETTO GBA RAILROAD MEDICARE
MI11281469OtherCAQH
MI383474955OtherCOMMERCIAL
MI7867019OtherAETNA
MI95 0D114800OtherBLUE CROSS BLUE SHIELD
MI383474955OtherCOMMERCIAL
MIDF3289OtherPALMETTO GBA RAILROAD MEDICARE