Individual
DR. KIEMANH PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5801 SMITH AVE, SUITE 3220, BALTIMORE, MD 21209-3652
(410) 735-6403
(410) 735-6425
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A99032
CA
207P00000X
Emergency Medicine Physician
Primary
D69427
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025242500
—
MD
01
—
D69427
MD LICENSE
MD
Enumeration date
08/07/2008
Last updated
12/08/2021
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