Provider Demographics
NPI:1801956495
Name:KAM, LAURANCE W (MD)
Entity type:Individual
Prefix:DR
First Name:LAURANCE
Middle Name:W
Last Name:KAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6715 LITTLE RIVER TPKE STE 300
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3546
Mailing Address - Country:US
Mailing Address - Phone:703-751-6668
Mailing Address - Fax:703-642-1049
Practice Address - Street 1:6715 LITTLE RIVER TPKE STE 300
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3546
Practice Address - Country:US
Practice Address - Phone:703-751-6668
Practice Address - Fax:703-642-1049
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101232306207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA114451OtherANTHEM
VA010062730Medicaid
J4230003OtherCAREFIRST
F57564Medicare UPIN
VAG0142402Medicare ID - Type UnspecifiedMETRO DC AREA