Provider Demographics
NPI:1194273847
Name:TAM, KEVIN KAR-FAI (PA-C, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:KAR-FAI
Last Name:TAM
Suffix:
Gender:M
Credentials:PA-C, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:16 DENDRON CT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1546
Mailing Address - Country:US
Mailing Address - Phone:301-524-9177
Mailing Address - Fax:
Practice Address - Street 1:16 DENDRON CT
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-1546
Practice Address - Country:US
Practice Address - Phone:301-524-9177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program