Individual
DEAN HUY PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPARTMENT, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2023018543
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023018543
MISSOURI STATE BOARD OF REGISTRATIONS FOR THE HEALING ARTS
MO
01
—
75000090A
INDIANA PROFESSIONAL LICENSING
IN
Enumeration date
12/05/2019
Last updated
12/03/2025
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