Individual
DR. NGOC BAO PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
625 BEAVER RUIN RD NW STE E, LILBURN, GA 30047-3407
(678) 369-9399
(833) 464-3867
Mailing address
625 BEAVER RUIN RD NW STE E, LILBURN, GA 30047-3407
(678) 369-9399
(770) 733-1370
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
73360
GA
Other
Enumeration date
06/08/2012
Last updated
10/28/2024
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