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Individual

PHUNG PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
333 NW 70TH AVE STE 107, PLANTATION, FL 33317-2358
(954) 998-6359
Mailing address
8087 N SAVANNAH CIR, DAVIE, FL 33328-3031
(954) 326-2781

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME118146
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015825700
FL
Enumeration date
06/09/2010
Last updated
04/23/2024
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