Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 35051898L | OH |
NPI | 1396745444 |
---|---|
Provider Name | Mei Chiew Lai |
First Address | Crestline, OH 44827-1028 |
Second Address | Crestline, OH 44827-1028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 26/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000154686 | ANTHEM (01) | OH |
0593513 | (05) | OH |
A16142 | (02) |