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General NPI Number Information
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NPI Number | 1851372551
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Entity Type | Individual
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Provider Name | DANIEL H LYNAM PA C
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 1141 N ROAD ST SUITE G
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City | ELIZABETH CITY
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State | NC
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Zip | 27909
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Country | US
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Telephone | 252-335-5424
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Fax | 252-335-1077
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Provider Business Mailing Address
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Address Line | 1833 PEARTREE RD
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-7817
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Country | US
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Telephone | 252-331-7773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 102249
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License Number State | NC
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