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NPI Code Detail

MEDICARE: TIMOTHY SIMON LAM PHARMD

MEDICARE: TIMOTHY SIMON LAM PHARMD
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
11835C0205XCritical Care Pharmacist121730MN

General Provider Information

NPI Number : 1295325561
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY SIMON LAM PHARMD
Provider Business Mailing Address
First Line : 730 SOUTH 8TH STREET
Second Line : RL 120
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 516-270-4092
Fax Number :
Provider Business Practice Location Address
First Line : 701 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55415-1623
Country : US
Telephone Number : 612-873-7114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2021
Last Update Date : 01/21/2021

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