Individual
CASSIE BLANKENSHIP LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 J CLYDE MORRIS BLVD, RIVERSIDE REGIONAL MEDICAL CENTER, NEWPORT NEWS, VA 23601-1929
(757) 594-2000
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2921
(703) 766-9737
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0101250862
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
VA
Enumeration date
05/16/2008
Last updated
02/24/2015
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