Basic Information
| Provider Information | |||||||||
| NPI: | 1275576316 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMM | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 45TH ST | ||||||||
| Address2: | KIMMEL BLDG | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618445255 | ||||||||
| FaxNumber: | 5618445245 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 45TH ST | ||||||||
| Address2: | KIMMEL BLDG | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618445255 | ||||||||
| FaxNumber: | 5618445245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 08/03/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0004X | 01401 | MD | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | 207XX0004X | PO 3815 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00184622 | 01 | MD | R/R MEDICARE PROVIDER # | OTHER | 405437700 | 05 | MD | MEDICAID | CG3092 | 01 | MD | R/R MEDICARE GROUP # | OTHER |