Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD00018979 | WA |
NPI | 1720070139 |
---|---|
Provider Name | Michael J Lemberger |
First Address | Spokane, WA 99202-6010 |
Second Address | Spokane, WA 99202-6010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 03/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8174245 | (05) | WA |
A07280 | (02) |