Individual
HAU TRONG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
732 HARRISON AVE, PRESTON 5TH FLOOR, BOSTON, MA 02118-2309
(617) 414-6840
(617) 414-6710
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2079
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000540601
MEDICARE ID
MA
05
—
110013009A
—
MA
Enumeration date
03/31/2006
Last updated
09/28/2017
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