Provider Demographics
NPI:1386931814
Name:LAM, LAI SEE (MD)
Entity type:Individual
Prefix:DR
First Name:LAI SEE
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W RIVER DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1014
Mailing Address - Country:US
Mailing Address - Phone:563-336-3000
Mailing Address - Fax:563-327-2045
Practice Address - Street 1:1106 4TH AVE
Practice Address - Street 2:COMMUNITY HEALTH CARE
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-1231
Practice Address - Country:US
Practice Address - Phone:563-336-3000
Practice Address - Fax:563-327-2045
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-135027208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGMedicaid