Individual
DR. CUONG QUOC PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 BLOOMINGTON AVE, MINNEAPOLIS, MN 55404-3074
(612) 301-3433
(612) 627-4205
Mailing address
420 DELAWARE ST SE, 14-100 PHILLIPS WANGENSTEEN BUILDING, MMC 391, MINNEAPOLIS, MN 55455-0341
(612) 624-0990
(612) 625-3238
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54551
MN
208000000X
Pediatrics Physician
54551
MN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
54551
MN
Other
Enumeration date
09/06/2007
Last updated
03/23/2020
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