Organization
THEODORE S NAM MD PC
Active
Organization
THEODORE S NAM MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE S NAM MD (PHYSICIAN)
(610) 383-4990
Entity
Organization
Contact information
Practice address
219 REECEVILLE ROAD, COATESVILLE, PA 19320-0000
(610) 383-4990
(610) 383-4989
Mailing address
219 REECEVILLE ROAD, COATESVILLE, PA 19320-0000
(610) 383-4990
(610) 383-4989
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD436926
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102398917
—
PA
Enumeration date
11/24/2009
Last updated
06/14/2010
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