Provider Demographics
NPI:1619312147
Name:LEMBECK, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LEMBECK
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 1:1100 E HECTOR ST
Mailing Address - Street 2:STE 105
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2320
Mailing Address - Country:US
Mailing Address - Phone:610-828-2608
Mailing Address - Fax:610-828-0102
Practice Address - Street 1:1100 E HECTOR ST
Practice Address - Street 2:STE 105
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2320
Practice Address - Country:US
Practice Address - Phone:610-828-2608
Practice Address - Fax:610-828-0102
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD455411207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine