Provider Demographics
NPI:1235561382
Name:LAM, TAI CHUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:TAI CHUNG
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:450 BROOKLINE AVENUE, DA 1105
Mailing Address - Street 2:DANA-FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5450
Mailing Address - Country:US
Mailing Address - Phone:617-525-6687
Mailing Address - Fax:617-394-2668
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DA 1105
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-525-6687
Practice Address - Fax:617-394-2668
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2550812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology