MEDICARE: DR. LOUIS WAI-KEI LAM M.D.

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	2083X0100X	Occupational Medicine Physician	MD044488L	PA

General Provider Information

NPI Number	:	1407067549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS WAI-KEI LAM M.D.

Provider Business Mailing Address
First Line	:	2801 ISLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2326
Country	:	US
Telephone Number	:	215-492-1173
Fax Number	:	215-492-1493

Provider Business Practice Location Address
First Line	:	2801 ISLAND AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19153-2326
Country	:	US
Telephone Number	:	215-492-1173
Fax Number	:	215-492-1493

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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