Individual
MO-PING MARLENE THAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
548 MARINE CORPS DR., TAMUNING, GU 96913
(671) 646-5825
Mailing address
PO BOX 6578, TAMUNING, GU 96931-6578
(671) 646-5825
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
M5540
TX
207Q00000X
Family Medicine Physician
Primary
M5540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190830301
—
TX
05
—
190830302
—
TX
01
—
8X7291
BCBS
TX
01
—
P00919164
RAILROAD MEDICARE
TX
Enumeration date
11/10/2006
Last updated
05/12/2016
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