Provider Demographics
NPI:1992192744
Name:LAM, SI TIEN (DO)
Entity Type:Individual
Prefix:DR
First Name:SI
Middle Name:TIEN
Last Name:LAM
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1648 HUNTINGDON PIKE
Mailing Address - Street 2:MEDICAL STAFF OFFICE 1ST FLR
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8001
Mailing Address - Country:US
Mailing Address - Phone:215-938-3450
Mailing Address - Fax:215-938-3829
Practice Address - Street 1:23 BUSTLETON PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6446
Practice Address - Country:US
Practice Address - Phone:215-464-0770
Practice Address - Fax:267-579-0720
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2021-07-07
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS018519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine