MEDICARE: DR. MICHAEL LAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MA68326	NJ

General Provider Information

NPI Number	:	1184656050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LAM MD

Provider Business Mailing Address
First Line	:	52 SHERWOOD AVE
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-1728
Country	:	US
Telephone Number	:	201-519-8152
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6911
Country	:	US
Telephone Number	:	201-969-0018
Fax Number	:	201-461-0838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	11/17/2020

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