Provider Demographics
NPI:1942352141
Name:TAM, ROLAND FOOK SENG (MD)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:FOOK SENG
Last Name:TAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 LILIHA ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1650
Mailing Address - Country:US
Mailing Address - Phone:808-531-7021
Mailing Address - Fax:808-531-7022
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:SUITE 409
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1650
Practice Address - Country:US
Practice Address - Phone:808-531-7021
Practice Address - Fax:808-531-7022
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD3110207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI19244411OtherHMA
HI03770702OtherALOHACARE
HIY4146-0OtherBLUECROSS BLUE SHIELD
HIY41460OtherHMSA
HI03770702Medicaid
HIMD3110OtherMDX
HIY41460OtherHMSA QUEST
HI990200508P1OtherHAWAII LABORERS
HIC98949Medicare UPIN
HIY41460OtherHMSA