Individual
HAN CAM PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 JOHNSON FERRY RD, ATLANTA, GA 30342
(404) 785-2490
(404) 785-5837
Mailing address
2076 ASGARD CT, ATLANTA, GA 30345
(404) 325-7955
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
25990
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009992435
—
AL
05
—
009992445
—
AL
Enumeration date
08/25/2006
Last updated
05/27/2009
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