Individual
DR. KHANH PHAM THIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 N EAGLE RD, SUITE 2, HAVERTOWN, PA 19083-3400
(610) 789-7546
(610) 789-7546
Mailing address
109 N EAGLE RD, SUITE 2, HAVERTOWN, PA 19083-3400
(610) 789-7546
(610) 789-7547
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
C1-0012141
DE
207N00000X
Dermatology Physician
Primary
MD454380
PA
207ND0900X
Dermatopathology Physician
C1-0012141
DE
207ND0900X
Dermatopathology Physician
MD454380
PA
Other
Enumeration date
03/29/2010
Last updated
03/20/2018
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