Provider Demographics
NPI:1538450820
Name:LAMB, ADRIENNE NICOLE (MD)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:NICOLE
Last Name:LAMB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:NICOLE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 WINDING DR STE 106
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2907
Mailing Address - Country:US
Mailing Address - Phone:267-787-6600
Mailing Address - Fax:267-787-6819
Practice Address - Street 1:1 WINDING DR STE 106
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2907
Practice Address - Country:US
Practice Address - Phone:267-787-6600
Practice Address - Fax:267-787-6819
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4495552084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry