Theodore S Nam MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD436926 Issued in PA

Legal business name

THEODORE S NAM MD PC

Practice address

219 Reeceville Road
Coatesville, PA 19320-0000

Phone

(610) 383-4990

Fax

(610) 383-4989

NPI assigned

Nov 24, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Theodore S Nam, MD

Title

Physician

Phone

(610) 383-4990

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1972831337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 REECEVILLE ROAD",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193200000",
            "telephone_number": "610-383-4990",
            "fax_number": "610-383-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 REECEVILLE ROAD",
            "city": "COATESVILLE",
            "state": "PA",
            "postal_code": "193200000",
            "telephone_number": "610-383-4990",
            "fax_number": "610-383-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE S NAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "NAM",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "610-383-4990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD436926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102398917",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Coatesville, PA
• Providers in Coatesville, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.