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Individual
THONG QUOC PHAM
Active
Individual
THONG QUOC PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
36077772
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
24761
NE
207RC0001X
Clinical Cardiac Electrophysiology Physician
36077772
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
7294
SD
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD-37909
IA
2085B0100X
Body Imaging Physician
36077772
IL
2085U0001X
Diagnostic Ultrasound Physician
36077772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077772 1
—
IL
01
—
101 15504
B/C B/S OF ILLINOIS
IL
05
—
1538188057
—
IA
01
—
CB0709/060028732
RR MEDICARE GROUP #/PIN
GA
Enumeration date
07/18/2006
Last updated
10/15/2015
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