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1114331204
TIDA LAM
WAKE FOREST, NC
NPI
1114331204
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MA 271164)
Enumeration Date
2014-06-17
Last Update Date
2019-05-07
Business Address
TIDA LAM D.O
1964 S MAIN ST
WAKE FOREST, NC 27587
Phone number: 919-554-0177
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Mailing Address
TIDA LAM D.O
10900 WORLD TRADE BLVD
RALEIGH, NC 27617-4202
Phone number: 630-740-0574
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