MEDICARE: DR. LOAN LAM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	PO 3302	FL

General Provider Information

NPI Number	:	1851557474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. LOAN LAM

Provider Business Mailing Address
First Line	:	3123 AVIAMAR CIR APT 104
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-9640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8340 COLLIER BLVD STE 400
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3626
Country	:	US
Telephone Number	:	239-919-2990
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/ OWNER
Name	:	DR. LOAN KIM LAM
Credential	:	D.P.M.
Telephone Number	:	239-793-4642

Provider Enumeration Date	:	08/03/2008
Last Update Date	:	08/03/2008

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Directions to “DR. LOAN LAM ” Practice Location

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