Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME85485 | FL |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME85485 | FL |
N | 207NP0225X | Pediatric Dermatologist | ME85485 | FL |
NPI | 1114919602 |
---|---|
Provider Name | David Anthony Lam |
First Address | Tampa, FL 33615-4518 |
Second Address | Tarpon Springs, FL 34689-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 04/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270809400 | (05) | FL |
H84705 | (02) | FL |