MEDICARE: DR. DAVID WONG LAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	25687	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295930972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WONG LAM MD

Provider Business Mailing Address
First Line	:	1011 N DEWEY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1024
Country	:	US
Telephone Number	:	405-228-7100
Fax Number	:	405-228-7150

Provider Business Practice Location Address
First Line	:	1011 N DEWEY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1024
Country	:	US
Telephone Number	:	405-228-7100
Fax Number	:	405-228-7150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	10/18/2020

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