Provider Demographics
NPI:1205819323
Name:LAM, LYN M (MD)
Entity Type:Individual
Prefix:DR
First Name:LYN
Middle Name:M
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7109
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7109
Mailing Address - Country:US
Mailing Address - Phone:808-885-7511
Mailing Address - Fax:808-885-0933
Practice Address - Street 1:65-1267 KAWAIHAE RD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8406
Practice Address - Country:US
Practice Address - Phone:808-885-7511
Practice Address - Fax:808-885-0933
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6412207VG0400X, 2088F0040X, 2471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone Densitometry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00I90580OtherHMSA
HIF00518Medicare UPIN
HI00I90580OtherHMSA