Provider Demographics
NPI:1730854290
Name:BENJAMIN KAM MD PC
Entity type:Organization
Organization Name:BENJAMIN KAM MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-661-8050
Mailing Address - Street 1:PO BOX 64558
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80962-4558
Mailing Address - Country:US
Mailing Address - Phone:719-661-8050
Mailing Address - Fax:
Practice Address - Street 1:1625 MEDICAL CENTER PT STE 215
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5798
Practice Address - Country:US
Practice Address - Phone:719-452-8509
Practice Address - Fax:719-453-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty