Individual
SON PHUONG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4881 SUGAR MAPLE DR, DAYTON, OH 45433-5529
(937) 257-0770
Mailing address
88 MDG/SGHJ, 4881 SUGAR MAPLE DR., WPAFB, OH 45433
(937) 257-0770
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.099741
OH
2083A0100X
Aerospace Medicine Physician
35.099741
OH
Other
Enumeration date
04/04/2011
Last updated
02/07/2023
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