Provider Demographics
NPI:1548435464
Name:LAMPKIN, SHANAIL RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:SHANAIL
Middle Name:RENEE
Last Name:LAMPKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHANAIL
Other - Middle Name:
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12520 EDGEWATER DR APT 1408
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1607
Mailing Address - Country:US
Mailing Address - Phone:219-384-5416
Mailing Address - Fax:
Practice Address - Street 1:3609 PARK EAST DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4331
Practice Address - Country:US
Practice Address - Phone:216-778-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH098735208000000X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics