Doctor Name: | QUINTA LUM |
NPI Number: | 1568773943 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | C0004189 |
Business Practice Address: | 957 National Hwy Lavale, MD - 215027356 |
Business Phone Number: | 3017299475 |
Business Fax Number: | 3017299474 |
Mailing Address: | 957 National Hwy, LAVALE |
State: | MD |
Postal Code: | 215027356 |
Phone Number: | 3017299475 |
Fax Number: | 3017299474 |
NPI Enumeration Date: | 06/30/2010 |
NPI Last Update Date: | 06/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0200X |
License Number: | C0004189 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |