Healthcare Provider Details

I. General information

NPI: 1992858443
Provider Name (Legal Business Name): TAM THANH-THI LY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KEMPSVILLE RD STE 100F
NORFOLK VA
23502-3920
US

IV. Provider business mailing address

850 KEMPSVILLE RD STE 100F
NORFOLK VA
23502-3920
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-5910
  • Fax: 757-275-9935
Mailing address:
  • Phone: 757-261-5910
  • Fax: 757-275-9935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101237779
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: