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NPI Code Detail

MEDICARE: MR. GREYARD R LAMM PA-C

MEDICARE:  MR. GREYARD R LAMM  PA-C
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
1363AS0400XSurgical Physician Assistant5601002271MI

General Provider Information

NPI Number : 1326019126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREYARD R LAMM PA-C
Provider Business Mailing Address
First Line : 2478 IVANHOE DR
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48324-1738
Country : US
Telephone Number : 248-738-4412
Fax Number :
Provider Business Practice Location Address
First Line : 461 W HURON ST
Second Line :
City : PONTIAC
State : MI
Zip : 48341-1601
Country : US
Telephone Number : 248-857-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 11/13/2008

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Directions to “ MR. GREYARD R LAMM PA-C” Practice Location

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