| Lam Medical, LLC | |
|
2040 S Calhoun St Fort Wayne IN 46802-6412 | |
| (260) 444-5695 | |
| (260) 444-5665 |
| Full Name | Lam Medical, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2040 S Calhoun St, Fort Wayne, Indiana |
| Authorized Official Name and Position | Lluvia E Saran (PARTNER) |
| Authorized Official Contact | 2604445695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lam Medical, LLC 2040 S Calhoun St Fort Wayne IN 46802-6412 Ph: (260) 444-5695 | Lam Medical, LLC 2040 S Calhoun St Fort Wayne IN 46802-6412 Ph: (260) 444-5695 |
| NPI Number | 1932856978 |
|---|---|
| Provider Enumeration Date | 03/09/2022 |
| Last Update Date | 03/09/2022 |
| Certification Date | 03/09/2022 |
| Medicare PECOS PAC ID | 7214310929 |
|---|---|
| Medicare Enrollment ID | O20220812002284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932856978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Eromonsele O Idahosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588659924 PECOS PAC ID: 0749202877 Enrollment ID: I20060104000262 |
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