Provider Demographics
NPI:1295737153
Name:LAMBERNEDIS, ANN M (MD,)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:LAMBERNEDIS
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:AKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2585 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1642
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:111 GREAT TEAYS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9548
Practice Address - Country:US
Practice Address - Phone:304-757-8803
Practice Address - Fax:304-757-8803
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV181652080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0110154000Medicaid