Individual
DR. TED T LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
509 SHERIDAN RD, NOBLESVILLE, IN 46060-1317
(317) 678-6402
(317) 678-6408
Mailing address
509 SHERIDAN RD, NOBLESVILLE, IN 46060-1317
(317) 678-6402
(317) 678-6408
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01059160
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201338640A
MEDICAID LEGACY PI
IN
05
—
I18282
—
IN
Enumeration date
09/29/2005
Last updated
02/09/2017
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