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General NPI Number Information
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NPI Number | 1477688315
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Entity Type | Organization
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Legal Business Name | WING LAM OD, PLLC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 730 VENTURE DR
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City | MORGANTOWN
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State | WV
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Zip | 26508-7306
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Country | US
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Telephone | 304-292-7240
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Fax |
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Provider Business Mailing Address
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Address Line | 730 VENTURE DR
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City | MORGANTOWN
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State | WV
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Zip | 26508-7306
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Country | US
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Telephone | 304-292-7240
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WING C LAM
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Credential | O.D.
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Telephone | 304-292-7240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 980-OD
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License Number State | WV
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