Individual
DR. AN T PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1370 DORCHESTER AVE, STE 23, DORCHESTER, MA 02122-2921
(617) 288-8883
(617) 288-8887
Mailing address
1370 DORCHESTER AVE, STE 23, DORCHESTER, MA 02122-2921
(617) 288-8883
(617) 288-8887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82073
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110057033A
—
MA
Enumeration date
08/08/2006
Last updated
11/30/2016
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