TIDA LAM (NPI# 1114331204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114331204 |
| Entity Type | Individual |
| Full Name | TIDA LAM |
| Credential | D.O |
| Practice Address |
1964 S Main St Wake Forest NC 27587 |
| Mailing Address |
10900 World Trade Blvd Raleigh NC 27617-4202 |
| Practice Telephone | 9195540177 |
| Practice Fax Number | 9195549277 |
| Mailing Telephone | 6307400574 |
| Mailing Fax Number | 6032287307 |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2019-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 271164 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 135 Jackson St, Lowell, MA 018522103 | 9789379700 | |
| 1964 S Main St, Wake Forest, NC 275879336 | 9195540177 | 9195549277 |
| Street Address |
1964 S MAIN ST |
| City | WAKE FOREST |
| State | NC |
| Zip Code | 27587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316226442 | Manuel Evangelos Bulauitan | Family Medicine | 1964 S Main St, Wake Forest, NC 27587 | 2011-08-07 |
| 1174911424 | Alignment Healthcare Medical Associates PC | Clinic/Center | 1964 S Main St, Wake Forest, NC 27587-9336 | 2015-01-08 |
| 1649684879 | Courtney Hudson Hinton | Family Medicine | 1964 S Main St, Wake Forest, NC 27587-9336 | 2014-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713080 | Catherine Restrepo | Speech-Language Pathologist | 900 S Franklin St, Ste 201, Wake Forest, NC 27587 | 2020-06-03 |
| 1942760277 | Samantha Fae Pugh | Occupational Therapist | 200 Dr. Calvin Jones Hwy, Suite 200, Wake Forest, NC 27587 | 2019-03-22 |
| 1851863609 | The Counseling Collective | Counselor | 1764 Heritage Center Drive, 204, Wake Forest, NC 27587 | 2018-12-18 |
| 1891270856 | Halston Hoke | Speech-Language Pathologist | 620 Dr. Calvin Jones Hwy Ste 200, Wake Forest, NC 27587 | 2018-09-26 |
| 1710465620 | Amy K Tarnowski | Physical Therapist | The Lodge At Wake Forest, 1151 South Main Street, Wake Forest, NC 27587 | 2018-08-02 |
| 1518452341 | Language and Literacy 365, Pllc | Speech-Language Pathologist | 956 Templeridge Rd, Wake Forest, NC 27587 | 2018-06-25 |
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1124544499 | Carolina Concussion & Physical Medicine, Pllc | Chiropractor | 120 Capcom Aveune, Suite 104, Wake Forest, NC 27587 | 2017-08-18 |
| 1902293889 | Katherine Armine Lorch | Student in an Organized Health Care Education/Training Program | 3000 Rogers Road Ste 210, Wake Forest, NC 27587 | 2015-04-18 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| Find all providers in zip 27587 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497119085 | Swathi Bindu Anche | Family Medicine | 11640 Northpark Dr Ste 100, Wake Forest, NC 27587-5741 | 2016-04-08 |
| 1336526383 | Family First Primary Care Pllc | Family Medicine | 3150 Rogers Rd Ste 101, Wake Forest, NC 27587-4196 | 2015-04-29 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| 1316226442 | Manuel Evangelos Bulauitan | Family Medicine | 1964 S Main St, Wake Forest, NC 27587 | 2011-08-07 |
| 1922290881 | Philip D. Burton M.d. Pllc | Family Medicine | 123 Cap Com Avenue, Suite One, Wake Forest, NC 27587-6517 | 2007-08-15 |
| 1659571768 | Novant Medical Group, Inc. | Family Medicine | 3213 Rogers Road, Wake Forest, NC 27587-3805 | 2007-07-18 |
| 1073661690 | Fastmed PC | Family Medicine | 2001 S. Main St, Wake Forest, NC 27587 | 2007-01-08 |
| 1568546430 | John Brinkley Sugg | Family Medicine | 11635 Capital Blvd Ste 200, Wake Forest, NC 27587-9350 | 2006-10-25 |
| 1740375443 | Robert W Gardner | Family Medicine | 3150 Rogers Rd, Suite 101, Wake Forest, NC 27587-4195 | 2006-10-04 |
| 1760417075 | Neighborhood Medical Centers, Inc | Family Medicine | 1002 Durham Rd Ste 800, Wake Forest, NC 27587-9173 | 2006-07-12 |
| Find all providers in WAKE FOREST | ||||
| City | WAKE FOREST |
| Zip Code | 27587 |
Please comment or provide details below to improve the information on TIDA LAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.