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Organization
PHAM MEDICAL ASSOCIATES PC
Active
Organization
PHAM MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE PHAM MD (PRESIDENT)
(800) 927-0002
Entity
Organization
Contact information
Practice address
1996 CENTRE ST, WEST ROXBURY, MA 02132-3329
(617) 469-0470
Mailing address
PO BOX 9137, BROOKLINE, MA 02446-9137
(800) 927-0002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9733710
—
MA
Enumeration date
12/27/2005
Last updated
01/14/2010
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