Provider Demographics
NPI:1053124669
Name:LAMBROS, BENJAMIN MARK
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MARK
Last Name:LAMBROS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 WOODSIA WAY APT 308
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8068
Mailing Address - Country:US
Mailing Address - Phone:919-943-3791
Mailing Address - Fax:
Practice Address - Street 1:280 WOODSIA WAY APT 308
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8068
Practice Address - Country:US
Practice Address - Phone:919-943-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker