# THONG QUOC PHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538188057
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | MD-37909 | IA | Yes |
| 2085B0100X | Body Imaging Physician | 36077772 | IL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | 36077772 | IL | — |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 10/15/2015

## 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 |