Individual
DIEM B PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1201 NW 12TH ST, MOORE, OK 73170-1220
(405) 799-2244
Mailing address
1025 SW 129TH ST, OKLAHOMA CITY, OK 73170-6997
(405) 378-6722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12618
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861407827
—
OK
Enumeration date
08/29/2011
Last updated
08/29/2011
About Stedi
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