Provider Demographics
NPI:1689689259
Name:LAMBIE, MILENA DIANA (DO)
Entity Type:Individual
Prefix:DR
First Name:MILENA
Middle Name:DIANA
Last Name:LAMBIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27750 MIDDLEBELT RD
Mailing Address - Street 2:#150
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-5005
Mailing Address - Country:US
Mailing Address - Phone:248-476-4000
Mailing Address - Fax:248-477-7490
Practice Address - Street 1:27750 MIDDLEBELT RD STE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5007
Practice Address - Country:US
Practice Address - Phone:248-476-4000
Practice Address - Fax:248-477-7490
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010143152086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4930689Medicaid
MIP34570001Medicare PIN