Provider Demographics
NPI:1902045891
Name:LAMB, AIMEE RUTH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:RUTH
Last Name:LAMB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:RUTH
Other - Last Name:LABOWITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:18608 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3261
Mailing Address - Country:US
Mailing Address - Phone:248-987-2792
Mailing Address - Fax:
Practice Address - Street 1:18608 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3261
Practice Address - Country:US
Practice Address - Phone:248-987-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant