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Individual

CHARLES NAM

Active
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Individual

CHARLES NAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00032978
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0116426
L & I PROVIDER NUMBER
WA
01
5495135
AETNA PROVIDER NUMBER
WA
05
8178923
WA
01
91120349412
KPS PROVIDER NUMBER
WA
01
98371B002
TRICARE PROVIDER NUMBER
WA
01
NA7328
REGENCE RIDER NUMBER
WA
Enumeration date
05/27/2006
Last updated
11/03/2011
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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