Provider Information for 1003264896
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Dr. GA HIE NAM M.D.
Sex: Female
NPI: 1003264896
Last Updated: 2016-06-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1003264896 | ||||||||
| Enumeration Date | 2016-06-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 593 EDDY ST PROVIDENCE, RI 02903-4923 United States Phone: 401-444-5057 | Fax:401-444-8514 | ||||||||
| Primary Practice Address | 593 EDDY ST PROVIDENCE, RI 02903-4923 United States Phone: 401-444-5057 | Fax:401-444-8514 | ||||||||
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