Provider Demographics
NPI:1184212573
Name:DAM, VINH CAM
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:CAM
Last Name:DAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-5074
Mailing Address - Country:US
Mailing Address - Phone:207-465-2181
Mailing Address - Fax:207-465-4629
Practice Address - Street 1:9 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5074
Practice Address - Country:US
Practice Address - Phone:207-465-2181
Practice Address - Fax:207-465-4629
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-02
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA2363363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical