Provider Demographics
NPI:1720242936
Name:TAM MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:TAM MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED ASSOCIATE
Authorized Official - Prefix:MS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-338-6818
Mailing Address - Street 1:200 LINCOLN ST
Mailing Address - Street 2:301
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2418
Mailing Address - Country:US
Mailing Address - Phone:617-338-6818
Mailing Address - Fax:
Practice Address - Street 1:200 LINCOLN ST
Practice Address - Street 2:301
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2418
Practice Address - Country:US
Practice Address - Phone:617-338-6818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health