Provider Demographics
NPI:1194166280
Name:LAM, FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:312 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5620
Mailing Address - Country:US
Mailing Address - Phone:505-326-6521
Mailing Address - Fax:505-325-6699
Practice Address - Street 1:812 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5631
Practice Address - Country:US
Practice Address - Phone:053-266-5215
Practice Address - Fax:505-325-6699
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2018-0778207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410004Medicare Oscar/Certification