Individual
TIMOTHY L TAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2240 RIDGEWOOD RD, STE 100, WYOMISSING, PA 19610-1167
(610) 376-8691
(610) 376-8745
Mailing address
2240 RIDGEWOOD RD, STE 100, WYOMISSING, PA 19610-1167
(610) 376-8691
(610) 376-8745
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD424019
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06036
EPSDT
PA
05
—
1010441290001
—
PA
Enumeration date
06/08/2005
Last updated
07/08/2007
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