Healthcare Provider Details

I. General information

NPI: 1194063370
Provider Name (Legal Business Name): YEW HON LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CENTRE ST NW
CALGARY ALBERTA
T2E 2T4
CA

IV. Provider business mailing address

2201 CENTRE ST NW
CALGARY ALBERTA
T2E 2T4
CA

V. Phone/Fax

Practice location:
  • Phone: 403-984-3877
  • Fax: 403-453-8588
Mailing address:
  • Phone: 403-984-3877
  • Fax: 403-453-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4301099563
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: