Individual
DAT PHAT VU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 227-3450
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 227-3450
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11638
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/26/2015
Last updated
05/23/2022
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