Individual
AMBER NICOLE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
19490 SANDRIDGE WAY, SUITE 210, LEESBURG, VA 20176-2704
(703) 723-7504
(703) 723-7550
Mailing address
224-D CORNWALL ST., NW SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008022
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578132692
—
VA
05
—
30016006070001
—
VA
Enumeration date
06/22/2021
Last updated
11/26/2024
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