Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME86272 | FL |
NPI | 1003870734 |
---|---|
Provider Name | Dr. Evan H Schlam |
First Address | Miami, FL 33136-1002 |
Second Address | Miami, FL 33136-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 29/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2696347-00 | (05) | FL |
44027 | (02) | FL |
I07039 | (02) | FL |