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NPI Code Detail

MEDICARE: MAI TRUC LAM MD

MEDICARE: MAI TRUC LAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician307196LA

General Provider Information

NPI Number : 1598177305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAI TRUC LAM MD
Provider Business Mailing Address
First Line : 2120 DRIFTWOOD BLVD
Second Line :
City : KENNER
State : LA
Zip : 70065-3574
Country : US
Telephone Number : 504-443-9500
Fax Number : 504-443-9522
Provider Business Practice Location Address
First Line : 2120 DRIFTWOOD BLVD
Second Line :
City : KENNER
State : LA
Zip : 70065-3574
Country : US
Telephone Number : 504-443-9500
Fax Number : 504-443-9522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 01/18/2026

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Directions to “ MAI TRUC LAM MD” Practice Location

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