Provider Demographics
NPI:1609856707
Name:LAMB, LETA C (MD)
Entity type:Individual
Prefix:DR
First Name:LETA
Middle Name:C
Last Name:LAMB
Suffix:
Gender:F
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:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-1430
Mailing Address - Country:US
Mailing Address - Phone:828-254-1111
Mailing Address - Fax:828-251-2744
Practice Address - Street 1:90 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4021
Practice Address - Country:US
Practice Address - Phone:828-254-1111
Practice Address - Fax:828-251-2744
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97000852085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8910229Medicaid
E11235Medicare UPIN
NC2233817AMedicare PIN
NC8910229Medicaid