Individual
DR. ATHENA NGA PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 MITYLENE PARK DR, MONTGOMERY, AL 36117-3548
(205) 801-8378
(334) 273-7837
Mailing address
202 MITYLENE PARK DR, MONTGOMERY, AL 36117-3548
(334) 273-1122
(334) 273-7837
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20145
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51033969
BLUE CROSS
AL
Enumeration date
01/10/2007
Last updated
02/06/2024
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