Provider Demographics
NPI:1932164407
Name:LAMB, CLARENCE E (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:E
Last Name:LAMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:STE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-853-4731
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:6014 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1624
Practice Address - Country:US
Practice Address - Phone:513-731-1550
Practice Address - Fax:513-731-9836
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-045110L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0518069Medicaid
OH0541281Medicare PIN
OHH132711Medicare PIN
OH0518069Medicaid