Provider Demographics
NPI:1619946894
Name:LAMB, ALLAN DANA (DO)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:DANA
Last Name:LAMB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 WEST RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2350
Mailing Address - Country:US
Mailing Address - Phone:734-676-4996
Mailing Address - Fax:
Practice Address - Street 1:3851 WEST RD
Practice Address - Street 2:SUITE #3
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2350
Practice Address - Country:US
Practice Address - Phone:734-676-4996
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012651208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI02-5-82-0708-5OtherBCBS
MI02-5-82-0708-5OtherBCBS