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General NPI Number Information
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NPI Number | 1851462139
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Entity Type | Individual
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Provider Name | MO-PING MARLENE THAM DO
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Gender | Female
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 548 MARINE CORPS DR.
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City | TAMUNING
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State | GU
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Zip | 96913
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Country | US
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Telephone | 671-646-5825
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6578
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City | TAMUNING
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State | GU
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Zip | 96931-6578
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Country | US
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Telephone | 671-646-5825
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | M5540
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M5540
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License Number State | TX
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