Provider Demographics
NPI:1518250026
Name:LAM, TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:LAM
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 1:3340 PROVIDENCE DR STE 366
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4627
Mailing Address - Country:US
Mailing Address - Phone:907-563-3026
Mailing Address - Fax:907-562-6445
Practice Address - Street 1:3340 PROVIDENCE DR STE 366
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4627
Practice Address - Country:US
Practice Address - Phone:907-563-3026
Practice Address - Fax:907-562-6445
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123116208000000X
AK1475052080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics