Individual
DR. PHUNG T DANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12414 STRATFORD RIDGE CT, SAINT LOUIS, MO 63141-6383
(314) 277-2163
Mailing address
12414 STRATFORD RIDGE CT, SAINT LOUIS, MO 63141-6383
(314) 277-2163
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
R5G74
MO
225400000X
Rehabilitation Practitioner
R5G74
MO
Other
Enumeration date
09/07/2006
Last updated
06/19/2015
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