Healthcare Provider Details

I. General information

NPI: 1225221047
Provider Name (Legal Business Name): CHECK C. KAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 SE MONTEREY RD STE 400
STUART FL
34994-4512
US

IV. Provider business mailing address

1050 SE MONTEREY RD SUITE 400
STUART FL
34994-4512
US

V. Phone/Fax

Practice location:
  • Phone: 772-288-2400
  • Fax: 772-419-0143
Mailing address:
  • Phone: 772-288-2400
  • Fax: 772-419-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME113451
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME113451
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberME113451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: