Provider Demographics
NPI:1093742314
Name:LAM, TONY C (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:C
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 STE GENEVIEVE DR
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-1434
Mailing Address - Country:US
Mailing Address - Phone:573-883-5715
Mailing Address - Fax:573-883-2463
Practice Address - Street 1:800 STE GENEVIEVE DR
Practice Address - Street 2:
Practice Address - City:STE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-1434
Practice Address - Country:US
Practice Address - Phone:573-883-5715
Practice Address - Fax:573-883-2463
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2P87207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology