Provider Demographics
NPI:1750449112
Name:LAMBERT, SEAN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:JOSEPH
Last Name:LAMBERT
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 1:1800 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8416
Mailing Address - Country:US
Mailing Address - Phone:770-886-3555
Mailing Address - Fax:770-205-6501
Practice Address - Street 1:1800 NORTHSIDE FORSYTH DR
Practice Address - Street 2:SUITE 350
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8416
Practice Address - Country:US
Practice Address - Phone:770-886-3555
Practice Address - Fax:770-205-6501
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000429503DMedicaid
GA16BDFZTMedicare PIN
GAD40398Medicare UPIN