Individual
AMY LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1169 N MAIN ST, SUITE 5, BLUFFTON, IN 46714-1360
(260) 827-4368
(260) 827-4370
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01055046A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200376870
—
IN
05
—
2407809
—
OH
Enumeration date
08/17/2005
Last updated
06/20/2016
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