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NPI Code Detail

MEDICARE: DIANA LAM PA-C

MEDICARE:   DIANA  LAM  PA-C
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
1363A00000XPhysician Assistant0110006216VA

General Provider Information

NPI Number : 1790262392
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA LAM PA-C
Provider Business Mailing Address
First Line : 11350 MCCORMICK RD
Second Line : EXECUTIVE PLAZA 1, STE 501
City : HUNT VALLEY
State : MD
Zip : 21031
Country : US
Telephone Number : 410-329-1071
Fax Number : 410-329-1054
Provider Business Practice Location Address
First Line : 2800 EISENHOWER AVE STE 200
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-5210
Country : US
Telephone Number : 703-562-9220
Fax Number : 703-520-7745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2018
Last Update Date : 11/04/2024

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Directions to “ DIANA LAM PA-C” Practice Location

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