Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | D40561 | MD |
NPI | 1114917937 |
---|---|
Provider Name | William Tham |
First Address | Annapolis, MD 21401-3046 |
Second Address | Annapolis, MD 21401-3046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 24/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4139559 | AETNA (01) | |
52125237 | MD BLUE SHIELD (01) | MD |
63990 | MAMSI HEALTH PLANS (01) | MD |
C4750001 | DC BLUE SHIELD (01) | DC |
E40070 | (02) |