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General NPI Number Information
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NPI Number | 1922492818
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Entity Type | Individual
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Provider Name | JOANNA KAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4238
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Country | US
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Telephone | 215-662-2777
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Fax | 215-662-4613
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Provider Business Mailing Address
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Address Line | 613 PONDER PLACE DR
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City | EVANS
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State | GA
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Zip | 30809-3187
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Country | US
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Telephone | 706-364-3223
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Fax | 706-364-4918
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 89046
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD469574
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License Number State | PA
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