Individual
DR. CHAUCHAU TU PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9711 COMMERCE CENTER CT, SUITE 101, FORT MYERS, FL 33908-3817
(239) 939-2621
(239) 939-3875
Mailing address
9711 COMMERCE CENTER CT, STE 101, FORT MYERS, FL 33908-3817
(239) 939-2621
(239) 939-3875
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME128776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
591315597
TAX ID
FL
Enumeration date
08/06/2012
Last updated
10/24/2016
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