Individual
STEPHEN PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 S ORANGE AVE, ORLANDO, FL 32806-2134
(407) 841-5111
(904) 346-0113
Mailing address
PO BOX 628296, ORLANDO, FL 32862-8296
(407) 741-9418
(904) 596-2761
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0075785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256530700
—
FL
01
—
46268
BCBS OF FL
FL
Enumeration date
09/03/2006
Last updated
07/30/2008
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