Provider Demographics
NPI:1841264231
Name:KAM, FREDERICK ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ANTHONY
Last Name:KAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3476
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-3476
Mailing Address - Country:US
Mailing Address - Phone:334-844-4416
Mailing Address - Fax:334-844-6126
Practice Address - Street 1:400 LEM MORRISON DRIVE
Practice Address - Street 2:
Practice Address - City:AUBURN UNIVERSITY
Practice Address - State:AL
Practice Address - Zip Code:36849-0001
Practice Address - Country:US
Practice Address - Phone:334-844-4416
Practice Address - Fax:334-844-6126
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL20353207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51501390OtherBLUECROSSBLUESHIELD OF AL