Individual
DR. VIVIEN PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Mailing address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
164816
CA
208000000X
Pediatrics Physician
Primary
4301504829
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2018
Last updated
06/24/2021
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