Provider Demographics
NPI:1386839975
Name:LAI-GOLDMAN, MYLA P (MD)
Entity Type:Individual
Prefix:DR
First Name:MYLA
Middle Name:P
Last Name:LAI-GOLDMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:128 MAPLE AVE
Mailing Address - Street 2:LABORATORY CORPORATION OF AMERICA
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5847
Mailing Address - Country:US
Mailing Address - Phone:336-436-5052
Mailing Address - Fax:336-436-1059
Practice Address - Street 1:128 MAPLE AVE
Practice Address - Street 2:LABORATORY CORPORATION OF AMERICA
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5847
Practice Address - Country:US
Practice Address - Phone:336-436-5052
Practice Address - Fax:336-436-1059
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC39294207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology