Provider Demographics
NPI:1801959770
Name:EDWARD H. SCHLAM M.D., P.A.
Entity type:Organization
Organization Name:EDWARD H. SCHLAM M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-741-5600
Mailing Address - Street 1:10044 NW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7005
Mailing Address - Country:US
Mailing Address - Phone:954-741-5600
Mailing Address - Fax:954-572-8574
Practice Address - Street 1:10044 NW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7005
Practice Address - Country:US
Practice Address - Phone:954-741-5600
Practice Address - Fax:954-572-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME20199174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053828100Medicaid
FL1760567101OtherNPI
FL1760567101OtherNPI
FL053828100Medicaid
FLAS5567752OtherDEA