Provider Demographics
NPI:1770598518
Name:LAI, CHI-KUANG (MD)
Entity type:Individual
Prefix:
First Name:CHI-KUANG
Middle Name:
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 1:117 EDDIE DOWLING HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7337
Mailing Address - Country:US
Mailing Address - Phone:401-597-0070
Mailing Address - Fax:401-597-0105
Practice Address - Street 1:117 EDDIE DOWLING HWY
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7337
Practice Address - Country:US
Practice Address - Phone:401-597-0070
Practice Address - Fax:401-597-0105
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09870207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7006597Medicaid
RI7006597Medicaid
RI0070600534Medicare PIN