Provider Demographics
NPI:1619488210
Name:SOKHARITH MEY, MD, PLLC
Entity Type:Organization
Organization Name:SOKHARITH MEY, MD, PLLC
Other - Org Name:LOWELL PRIMARY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOKHARITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-395-5525
Mailing Address - Street 1:1075 WESTFORD ST # 204
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2845
Mailing Address - Country:US
Mailing Address - Phone:978-455-7992
Mailing Address - Fax:978-221-6168
Practice Address - Street 1:1075 WESTFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2845
Practice Address - Country:US
Practice Address - Phone:978-395-5525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110120791AMedicaid