Provider Demographics
NPI:1396745444
Name:LAI, MEI CHIEW (MD)
Entity type:Individual
Prefix:
First Name:MEI
Middle Name:CHIEW
Last Name:LAI
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 1:293 CHAMBERS ST
Mailing Address - Street 2:P.O. BOX407
Mailing Address - City:CRESTLINE
Mailing Address - State:OH
Mailing Address - Zip Code:44827-1028
Mailing Address - Country:US
Mailing Address - Phone:419-683-3073
Mailing Address - Fax:419-683-3169
Practice Address - Street 1:293 CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-1028
Practice Address - Country:US
Practice Address - Phone:419-683-3073
Practice Address - Fax:419-683-3169
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051898L2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0593513Medicaid
OH000000154686OtherANTHEM
OH0593513Medicaid
OHLA0569931Medicare ID - Type Unspecified