Provider Demographics
NPI:1356329916
Name:TAM, PILAR G (MD)
Entity Type:Individual
Prefix:
First Name:PILAR
Middle Name:G
Last Name:TAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EAST GLEBE ROAD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305
Mailing Address - Country:US
Mailing Address - Phone:703-535-5568
Mailing Address - Fax:703-299-1794
Practice Address - Street 1:2 E GLEBE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22305-2938
Practice Address - Country:US
Practice Address - Phone:703-535-5568
Practice Address - Fax:703-299-1794
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238006208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF43578Medicare UPIN