Provider Demographics
NPI:1407176811
Name:LAM, KENT KWOK KIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:KWOK KIN
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-388-6200
Mailing Address - Fax:757-388-6201
Practice Address - Street 1:600 GRESHAM DR STE 1100
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-6200
Practice Address - Fax:757-388-6201
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260107207Y00000X, 207Y00000X
TXQ2790207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1407176811OtherUNITED HEALTHCARE
VA1407176811OtherCOVENTRY HEALTH CARE
VA1407176811OtherHUMANA
VA1407176811OtherVIRGINIA HEALTH NETWORK
VA1407176811OtherMULTIPLAN
VA1407176811OtherANTHEM BC/BS
VA1407176811OtherCORVEL
VA1407176811OtherVIRGINIA PREMIER HEALTH PLAN
VA1407176811OtherAETNA
VA1407176811Medicaid
VA1407176811OtherUSA MANAGED CARE
VA1407176811OtherOPTIMA HEALTH
NC1407176811Medicaid
VA1407176811OtherTRICARE/CHAMPUS
VA1407176811OtherCIGNA
VA1407176811OtherOPTIMA HEALTH