Individual
JEREMY LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 453-4500
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2006-0309
NM
Other
Enumeration date
02/06/2007
Last updated
02/23/2011
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