Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 35031830 | OH |
NPI | 1891712634 |
---|---|
Provider Name | Bradley Maurice Lemberg |
First Address | Cincinnati, OH 45240-3184 |
Second Address | Cincinnati, OH 45240-3184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 02/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0168956 | (05) | OH |
A71438 | (02) | OH |