Provider Demographics
NPI:1730315912
Name:LAMIS, PANO A (MD)
Entity Type:Individual
Prefix:DR
First Name:PANO
Middle Name:A
Last Name:LAMIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 FERRY LNDG NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3566
Mailing Address - Country:US
Mailing Address - Phone:770-859-9755
Mailing Address - Fax:
Practice Address - Street 1:415 FERRY LNDG NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3566
Practice Address - Country:US
Practice Address - Phone:770-859-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011768208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery