Provider Demographics
NPI:1215137120
Name:LAM, SARAH KRISTIN NICHOLSON (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTIN NICHOLSON
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:KRISTIN
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4-1461 KUHIO HWY
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1715
Mailing Address - Country:US
Mailing Address - Phone:808-220-7062
Mailing Address - Fax:
Practice Address - Street 1:4-1461 KUHIO HWY
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1715
Practice Address - Country:US
Practice Address - Phone:808-220-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15126208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics