Organization
PHAM INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICK PHAM M.D. (PRESIDENT)
(703) 533-7673
Entity
Organization
Contact information
Practice address
6408 SEVEN CORNERS PL STE F, FALLS CHURCH, VA 22044-2011
(703) 533-7673
Mailing address
PO BOX 2782, FAIRFAX, VA 22031-0782
(703) 533-7673
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101244284
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801082508
—
VA
Enumeration date
05/31/2012
Last updated
05/31/2012
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