Individual
HUNG TAN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E OLNEY AVE STE C5, PHILADELPHIA, PA 19120-2470
(215) 927-1937
(215) 456-6240
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS019654
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103803880
—
PA
Enumeration date
03/10/2017
Last updated
11/30/2020
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