MEDICARE: DR. JOYCE LUM PH.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	103T00000X	Psychologist	2615	NC

General Provider Information

NPI Number	:	1922266410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE LUM PH.D.

Provider Business Mailing Address
First Line	:	8401 UNIVERSITY EXEC PARK DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1360
Country	:	US
Telephone Number	:	919-445-2365
Fax Number	:	704-563-4112

Provider Business Practice Location Address
First Line	:	8401 UNIVERSITY EXEC PARK DR STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1360
Country	:	US
Telephone Number	:	919-445-2365
Fax Number	:	919-445-2353

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

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	03/30/2021

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