Healthcare Provider Details

I. General information

NPI: 1548102700
Provider Name (Legal Business Name): LILLIAN HAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILLY HAM

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

408 KATHRYN CT
YARDLEY PA
19067-3126
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3268
  • Fax: 410-955-0504
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: