MEDICARE: DR. GREGORY K.W. LAM M.D.

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	35094227	OH
2	207RC0000X	Cardiovascular Disease Physician	35-094227	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255319760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY K.W. LAM M.D.

Provider Business Mailing Address
First Line	:	5350 FRANTZ RD
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-4259
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N PICKAWAY ST
Second Line	:	SUITE 102
City	:	CIRCLEVILLE
State	:	OH
Zip	:	43113-1447
Country	:	US
Telephone Number	:	740-420-8174
Fax Number	:	740-420-8185

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	01/05/2022

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