Provider Demographics
NPI:1659315505
Name:LAM, CHEE KONG (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEE
Middle Name:KONG
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NICHOLAS
Other - Middle Name:CHEE
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9501 PASEO DEL NORTE NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2998
Mailing Address - Country:US
Mailing Address - Phone:505-821-9630
Mailing Address - Fax:505-821-1705
Practice Address - Street 1:9501 PASEO DEL NORTE NE
Practice Address - Street 2:SUITE B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-2998
Practice Address - Country:US
Practice Address - Phone:505-821-9630
Practice Address - Fax:505-821-1705
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2010-0607174400000X
TXM2998174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B0317OtherBCBS
TX149650701Medicaid
TX149650702OtherCSHCN
TX8X6130OtherBCBS
TX149650703Medicaid
TX149650701Medicaid
TX8531B1Medicare PIN
TX8X6130OtherBCBS
TX149650702OtherCSHCN