Individual
DR. LEYDA M SU HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5900 S LAKE DR, CUDAHY, WI 53110-3171
(414) 489-9000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101017869
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073715
—
WI
Enumeration date
06/25/2008
Last updated
12/15/2023
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