Individual
NIKKI PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105
(801) 464-7777
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 464-7777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10186730-1205
UT
Other
Enumeration date
07/23/2009
Last updated
06/12/2018
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