Individual
MARY WING SUM TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
57 NORTH ST STE 415, DANBURY, CT 06810-5629
(203) 628-4995
Mailing address
57 NORTH ST STE 415, DANBURY, CT 06810-5629
(203) 628-4995
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
275696
MA
207W00000X
Ophthalmology Physician
Primary
80895
CT
207W00000X
Ophthalmology Physician
960492
NY
207W00000X
Ophthalmology Physician
ME163116
FL
207W00000X
Ophthalmology Physician
T6053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053802454
—
CT
05
—
119673400
—
FL
Enumeration date
05/22/2018
Last updated
07/23/2025
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