Provider Demographics
NPI:1275576316
Name:LAMM, BRADLEY M (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:M
Last Name:LAMM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 45TH ST
Mailing Address - Street 2:KIMMEL BLDG
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2413
Mailing Address - Country:US
Mailing Address - Phone:561-844-5255
Mailing Address - Fax:561-844-5245
Practice Address - Street 1:901 45TH ST
Practice Address - Street 2:KIMMEL BLDG
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2413
Practice Address - Country:US
Practice Address - Phone:561-844-5255
Practice Address - Fax:561-844-5245
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01401207XX0004X
FLPO 3815207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00184622OtherR/R MEDICARE PROVIDER #
MD405437700Medicaid
MDCG3092OtherR/R MEDICARE GROUP #
MDU99849Medicare UPIN
MD956LI643Medicare PIN
FLIP37IZMedicare UPIN