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Individual

DR. DANIEL NAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
160 E MAIN ST, PORT JERVIS, NY 12771-2114
(845) 858-7000
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16377
NH
207R00000X
Internal Medicine Physician
25MA07999200
NJ
207R00000X
Internal Medicine Physician
306510
NY
207R00000X
Internal Medicine Physician
MD432587
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020277300001
PA
05
1020277300002
PA
05
1020277300003
PA
01
2089031
HIGHMARK BLUE SHIELD
PA
01
3432839000
BCBS OF PA
PA
Enumeration date
06/15/2006
Last updated
09/19/2024
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