Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD469574 | PA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 89046 | GA |
NPI | 1922492818 |
---|---|
Provider Name | Joanna Kam |
First Address | Evans, GA 30809-3187 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 23/07/2021 |